穿透导管大动脉植入后发生的脑血管事件
Pavan Reddy1, Ilan Merdler1, Itsik Ben-Dor1
1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, D.C., USA.
概括
过导管大动脉植入后的中风 (TAVI) 是一个主要问题. 本综述阐明了TAVI患者中风的原因和预防策略,以改善结果.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 干预心脏病学 干预心脏病学
背景情况:
- 通过导管大动脉植入术 (TAVI) 后的外科手术性中风是一种严重并发症,患病率高.
- 在过去十年中,TAVI后中风发病率一直保持一致,这可能是由于报告不足和各种确定方法.
- 在TAVI患者中,中风的多因素病因,加上不断变化的风险概况和设备,使风险因素的识别变得复杂.
研究的目的:
- 分析和澄清有关TAVI患者神经事件的流行病学和机制的当代文献.
- 在TAVI的背景下,评估潜在的中风预防措施.
- 增强患者风险评估,完善脑栓塞保护装置的选择.
主要方法:
- 对TAVI相关的神经事件发表文献的系统审查.
- 对流行病学数据和导致中风的病因因素的分析.
- 评估当前和潜在的中风预防策略.
主要成果:
- 脑卒中仍然是一个TAVI后持续的问题,影响患者的发病率.
- 报告不足和多样化的方法使准确的发病率评估变得复杂.
- 鉴定一致的中风风险因素是具有挑战性的,因为多因素的原因和不断发展的TAVI技术.
结论:
- 需要更清楚地了解TAVI相关的中风流行病学和机制.
- 改善风险分层和病例选择对于预防中风至关重要.
- 本综述为未来的研究和临床试验设计提供了基础,重点是缓解TAVI程序中的神经事件.
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