大核心缺血性中风的内血管治疗:真实世界的印度体验
Surabhi Garg1,2, Dileep Ramachandran1, Tanaya Mishra1
1Department of Neurology, Narayana Institute of Neurosciences, Majumdar Shaw Medical Centre, Narayana Health, Bengaluru, Karnataka, India.
Annals of Indian Academy of Neurology
|May 31, 2024
概括
大核心急性缺血性中风与大血管封闭 (LVO) 的内血管治疗 (EVT) 在印度患者中显示出有前途的现实世界结果. 这种干预对于被选中的个人来说是一个可行的选择,尽管存在一些风险.
科学领域:
- 神经学 神经学
- 干预神经病学 干预神经病学
- 脑卒中医学 脑卒中医学
背景情况:
- 大核心急性缺血性中风以前被排除在内血管治疗 (EVT) 试验之外,因为出血和不良结果的担忧.
- 最近的试验表明,EVT改善了大血管封闭 (LVO) 卒中的结果,尽管出血率较高,但没有症状性脑内出血 (sICH).
- 在印度,对大型核心LVO中风的EVT的现实数据有限.
研究的目的:
- 在印度人口中评估EVT对急性缺血性中风与大核心心脏病发作和LVO的实际有效性和安全性.
- 为了提供证据,考虑在选择的印度患者中进行EVT重度中风.
主要方法:
- 一个单一中心的回顾性观察研究分析了7年的前性循环中风的EVT前性循环数据.
- 包括患者的阿尔伯塔中风计划早期计算机断层扫描得分 (ASPECTS) 为3-5.
- 主要终点是90天修改的兰金尺度 (mRS) 评分;安全结果包括SICH和死亡率.
主要成果:
- 包括25名患者 (平均年龄为52.9岁,52%为男性),中位数为5的ASPECT.
- 在92%的患者中,成功地实现了再通道化 (修改后的脑梗塞血栓溶解得分).
- 良好的功能恢复 (90天的mRS 0-3) 发生在36%的患者中,sICH在16%的患者中,死亡率在36%的患者中.
结论:
- 印度患者的现实结果表明,EVT是选择LVO的大核心缺血性心脏病发作的一种可行的治疗方法.
- 这些发现支持在特定患者群体中使用EVT,与最近随机对照试验 (RCT) 证据保持一致.
- 这项研究为在多样化的人群中理解EVT提供了有价值的现实数据.
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