内血管治疗以改善中等血管封闭的结果:ESCAPE-MeVO试验
Johanna M Ospel1,2, Dar Dowlatshahi3, Andrew Demchuk1,2
1Department of Diagnostic Imaging, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada.
概括
由于中等血管封闭 (MeVO) 而导致的急性缺血性中风的内血管治疗 (EVT) 与单独的最佳医疗管理相比,显著改善了结果. 这项随机试验为优化MeVO中风护理提供了关键数据.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 由于中等血管封闭 (MeVO) 的急性缺血性中风,目前最好的医疗管理结果不佳.
- 缺乏关于MeVO中风的内血管治疗 (EVT) 的随机数据,这阻碍了基于证据的决策.
研究的目的:
- 为了证明与最佳医疗管理相比,MeVO中风患者急性,快速EVT的改善临床结果.
- 评估EVT在MeVO中风中的安全性,生活质量影响和成本效益.
主要方法:
- 一个多中心,前性,随机化,开放标签研究,盲目的终点评估 (PROBE设计).
- 530名因MeVO而患有急性缺血性中风的受试者符合EVT的条件,被随机分配1:1到最佳医疗保健加EVT或仅最佳医疗保健.
- 关键的资格标准包括:临床和技术上符合EVT资格的MeVO,最近在12小时内已知,NIHSS>5或3-5具有致残缺陷,以及可在神经成像上挽救的组织.
主要成果:
- 主要结局:修改了90天后的兰金尺度转移分析.
- 二次结果:mRS,NIHSS得分,死亡率,生活质量 (EQ-5D-5L),日常生活中的工具活动,再输质量,心脏病发作量和成本效益.
- 安全结果:有症状和无症状的内出血,以及程序并发症.
结论:
- 该ESCAPE-MeVO试验旨在提供关于EVT在MeVO引起的急性缺血性中风的疗效和安全性的强有力的证据.
- 结果将为MeVO中风患者的临床指南和治疗决策提供信息.
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