超导管大动脉置换后神经血管微血栓的患病率
Navneet Sharma1, Ryan F Heslin1, Saadat U Aleem1
1Division of Cardiology, Stony Brook University Medical Center, Stony Brook, New York.
概括
微栓塞,检测到高强度的短暂信号 (HITS),是常见的过导管大动脉置换 (TAVR) 后. 这些信号在TAVR后24小时持续存在,表明大多数患者正在进行微栓塞.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 通过导管大动脉置换 (TAVR) 后的神经系统后果导致患者显著的发病率和死亡率.
- 跨皮多普勒 (TCD) 成像检测到高强度的短暂信号 (HITS),表明有活跃的微栓塞.
- 在TAVR后的时期中,微栓塞的延续在很大程度上仍未得到研究.
研究的目的:
- 为了调查TAVR后时期的微栓塞的发生情况.
- 确定TAVR后微栓塞的潜在临床,程序或心声学预测因素.
主要方法:
- 在51名连续接受无保护TAVR的患者中使用TCD评估了HITS.
- 在手术前,手术期间和TAVR后24小时进行了TCD评估.
- 对于中脑动脉无声化的时间窗口不足的患者被排除在外.
主要成果:
- 在TAVR前没有检测到HITS;所有患者在手术期间都出现了HITS.
- 在TAVR后24小时观察到HITS (56.8%) 的显著流行率.
- 一位患有TAVR后HITS的患者在手术后48小时中风.
结论:
- 微血栓的高患病率在TAVR后24小时持续存在.
- 程序内微栓塞的预测因素似乎没有影响TAVR后的微栓塞.
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