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大型心脏病发作缺血性中风的内血管血栓切除术,短期和长期结果:对6项随机对照试验的元分析

Ali Mortezaei¹, Mahmoud M Morsy², Bardia Hajikarimloo³

¹Gonabad University of Medical Sciences, Gonabad, Iran.

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

|July 3, 2024

概括

血管内血栓切除术 (EVT) 与最佳医疗治疗 (BMT) 相比,改善了大核心缺血性心脏病发作的结果. EVT提供了更好的功能恢复和更低的死亡率,尽管出血风险略有增加.

科学领域:

神经学神经学
干预心脏病学干预心脏病学
脑卒中医学脑卒中医学

背景情况:

对于大核心缺血性心脏病发作 (LCI) 进行内血管血栓切除术 (EVT) 是一个有争议的问题.
对LCI的最佳治疗策略需要进一步研究.

研究的目的:

评估EVT加上最佳医疗治疗 (BMT) 与仅仅针对LCI患者的BMT的疗效和安全性.
分析短期和长期的功能结果和并发症率.

主要方法:

对四个随机对照试验 (RCT) 数据库进行系统的文献搜索,将EVT与LCI中的 BMT进行比较 (ASPECTS ≤ 5).
来自6个RCT的数据的元分析,其中包括1918名患者.
评估结果,包括修改的兰金表 (mRS) 评分,死亡率和出血率.

主要成果:

与单独使用BMT相比,EVT加BMT显著改善了90天的功能结果 (mRS 0-1, 0-2, 0-3) 并降低了死亡率.
EVT与较高的症状和任何内出血 (ICH) 相关.
一年后的结果也有利于EVT用于功能恢复,死亡率没有显著差异.

结论:

在改善LCI患者的短期和长期功能结果方面,EVT加BMT优于单独的BMT.
EVT的好处伴随着小幅增加出血风险.
对于精心挑选的LCI患者,EVT应该被视为一种有价值的治疗选择.

关键词:

血管内血栓切除术血管内血栓切除术大型核心冲击中风.低的方面低的方面

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