穿透性脑血管损伤中发生中风的危险因素
Alexander D DiBartolomeo1, Brian Williams2, Fred A Weaver1
1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA.
Journal of vascular surgery
|June 7, 2024
概括
透性脑血管损伤 (PCVI) 的管理是有争议的. 临时的血管内变流显示了高的中风和死亡率,这表明它可能不适合PCVI损害控制.
科学领域:
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 脑血管疾病 脑血管疾病
背景情况:
- 透性脑血管损伤 (PCVI) 携带死亡率和神经缺陷的重大风险.
- 对PCVI的最佳管理策略,特别是那些需要损害控制的策略,仍然是有争议的.
- 创伤外科医生主要在这个1级创伤中心管理血管损伤.
研究的目的:
- 描述1级创伤中心PCVI的管理方法.
- 评估PCVI治疗后患者的结果,包括中风和死亡率.
- 为了比较不同动脉干预策略的结果:修复,绑定/栓塞和暂时的血管内转移.
主要方法:
- 一项为期10年的机构创伤注册表审查 (2011-2021) 确定了患有PCVI的患者.
- 包括的伤害涉及常见动脉 (CCA),内动脉 (ICA) 或脊椎动脉.
- 主要结局是住院中风;次要结局包括死亡率和中风或死亡,并对干预类型进行子组分析.
主要成果:
- 分析了54名PCVI患者;整体住院中风率为17%,死亡率为26%.
- 在21名患者中进行了动脉干预:10例修复,6例绑定/栓塞,5例临时分流.
- 脑卒中发生率差异很大:30% (修复),0% (结/栓塞) 和80% (移动);移动也具有100%的中风或死亡率.
结论:
- 针对PCVI的损害控制策略,特别是暂时的血管内转移,与高中风和死亡率有关.
- 临时的血管内转移显示了特别高的入院中风发病率和100%的中风或死亡率.
- 需要进行进一步的研究,以调查导致这些结果的因素以及PCVI中临时变流的建议性.
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