在早期mTICI 2b之后,停止或继续? 来自PERSIST注册表的洞察力
Yachen Ji1, Xianhui Ding1, Lulu Xiao2
1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China.
Annals of clinical and translational neurology
|June 12, 2024
概括
在脊柱塞的内血管血栓切除术后,在脑梗塞 (mTICI) 3重灌等级中实现修改型血栓溶解是最好的,采用较少的取回尝试. 在初始mTICI 2b后继续检索超过两次尝试不会改善预后.
科学领域:
- 神经学 神经学
- 干预性放射学 干预性放射学
- 血管医学 血管医学
背景情况:
- 血管内血栓切除术 (EVT) 后更高的再输血度与更好的患者预后相关.
- 多次检索尝试对脊柱关 (VBAO) EVT结果的影响仍然不清楚.
研究的目的:
- 调查VBAO患者中检索尝试数量与再输度等级之间的关系.
- 确定在EVT后追求更高的再输血等级超出初始mTICI 2b后是否会改善临床结果.
主要方法:
- 对接受VBAO的EVT患者的多中心注册表数据集的回顾性分析.
- 收录标准:成功的再注射 (mTICI 2b/3).
- 回归模型通过检索尝试对预后和出血进行分析,分析了再输血等级.
主要成果:
- 包括432名患者;34.5%实现了mtci2b,65.5%实现了mtci3.
- 在第一次通过时达到mTICI 3显著增加了良好的预后的几率.
- 超过第一次通过后的检索尝试增加与良好的预后机会降低相关;经过3+次通过后的结果与初始mtci2b相似.
结论:
- 在两次检索尝试中实现的mtci3优于第一次检索后的mtci2b.
- 在VBAO EVT中初始的mTICI 2b之后,应谨慎地进行进一步的检索尝试,因为预后回报率下降.
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