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在缺血性中风患者的血栓切除术中,在后面和前面的循环中出现了双重闭塞

Manuel Cappellari¹, Giovanni Pracucci², Valentina Saia³

¹Stroke Unit, DAI Di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Piazzale A. Stefani 1, 37126, Verona, Italy. manuel_cappellari@libero.it.

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|June 18, 2024

概括

在急性缺血性中风患者中,机械血栓切除术 (MT) 对于后侧关闭 (p-TO) 与前侧关闭 (a-TO) 相比,与更糟糕的结果有关. 这24小时的治疗窗口显示,p-TO的良好的康复概率较低,死亡风险增加.

科学领域:

神经学神经学
干预性神经放射学干预性神经放射学
脑卒中医学脑卒中医学

背景情况:

机械血栓切除术 (MT) 已被确立为急性缺血性中风与前方并列闭塞 (a-TO) 的有益.
关于MT在急性缺血性中风与后方合性闭塞 (p-TO) 的疗效的数据有限.
本研究解决了关于p-TO与a-TO中MT结果的知识差距.

研究的目的:

为了比较机械血栓切除术 (MT) 在24小时内在急性缺血性中风患者的后侧关闭 (p-TO) 与前侧关闭 (a-TO) 的结果.
评估p-TO与功能独立性和MT后3个月死亡率的关联.

主要方法:

一项使用意大利急性中风内血管治疗注册局 (IRETAS) 前性收集数据的队列研究.
包括在24小时内接受MT治疗的急性缺血性中风患者,p-TO (n=275) 或a-TO (n=1853).
统计分析涉及对手术前,手术前和手术后变量进行调整,包括脑中风前修改的兰金度量表 (mRS) 评分.

主要成果:

在多变量调整后,p-TO显著与达到0-2 (或0.415-0.444) 修改的兰金尺度 (mRS) 得分的可能性较低有关.
后侧关闭 (p-TO) 也与3个月后死亡风险更高 (OR 2.813-2.971) 有显著的关联.
在调整了各种临床,程序和程序后因素后,这些关联仍然很重要.

结论:

在24小时内对急性缺血性中风患者进行机械血栓切除术 (MT),后侧关闭 (p-TO) 与前侧关闭 (a-TO) 相比,3个月后的功能结果更差.
接受MT的p-TO患者面临着明显更高的死亡风险.
可能需要进一步的研究来优化对p-TO的MT策略.

关键词:

在前面的LVO.在后面的LVO.一次性中风,中风.双重闭合双重闭合进行血栓切除术 (thrombectomy).

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