关于管理专利的SCAI技术审查Foramen Ovale
Andrew M Goldsweig1, Sarosh P Batlivala2, Karim Al-Azizi3
1Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
概括
与抗血小板治疗相比,通过透管专利的卵孔 (PFO) 关闭有效地降低了选择患者的复发性中风风险. 然而,对TIA或偏头痛等其他疾病的证据仍然不那么强大.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床证据综合研究
背景情况:
- 形孔 (PFO) 是一种常见的解剖变异,与右向左的变形有关.
- 通过导管PFO关闭正在探索诸如中风,TIA,偏头痛和减压疾病等情况.
研究的目的:
- 在各种临床场景中系统地审查跨导管PFO关闭的证据.
- 为解决SCAI指南小组关于PFO关闭结果提出的具体问题.
主要方法:
- 使用GRADE方法进行了系统审查.
- 文献搜索涵盖2015年1月至2021年5月,数据提取和偏差风险评估.
- 对于PICO格式的问题,确定了聚合效应估计和证据确定性.
主要成果:
- 30项研究符合2701个最初标题中的资格标准.
- 过导管PFO关闭表明,与此前中风患者的抗血小板治疗相比,复发性中风的风险降低了.
- 支持PFO关闭的证据对于老年患者,抗凝血剂,血栓形成症,TIA,偏头痛和减压疾病来说较弱.
结论:
- 过导管PFO关闭对精选的中风患者有好处,减少复发风险与抗血小板单一治疗相比.
- 需要进一步的证据来支持其他迹象的PFO关闭.
- 调查结果将为即将发布的SCAI指导方针提供信息.
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