由流量转移引起的血栓栓塞事件的时间,类型和影响:10年经验
Felipe Ramirez-Velandia1,2, Jean Filo1,2, Alejandro Enriquez-Marulanda1,2
11Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston; and.
Journal of neurosurgery
|August 16, 2024
概括
流量转移 (FD) 后的血栓栓塞事件影响患者的结果,阿司匹林耐药性是关键预测因素. 了解这些因素对于管理FD手术后的并发症至关重要.
科学领域:
- 神经学 神经学
- 干预性放射学 干预性放射学
- 血管外科 血管外科
背景情况:
- 血栓栓塞 (TE) 事件在动脉瘤治疗的流量转移 (FD) 后是一个重大问题.
- 尽管进行了充分的双重抗血小板治疗,但这些事件仍然可能发生,因此需要进一步调查导致因素和结果.
研究的目的:
- 描述FD后的血栓和栓塞事件.
- 确定易感因素,并评估与FD后的TE事件相关的发病率.
主要方法:
- 651个FD手术对746个动脉瘤 (2013-2023) 的回顾性分析.
- 在手术内和手术后的TE事件的记录.
- 生存分析和考克斯回归以确定TE事件的预测因素.
主要成果:
- TE事件发生在5.8%的手术中,导致20名患者的永久缺陷和4名患者的死亡.
- 观察到急性支架血栓,大血管封闭和穿孔器中风.
- 阿司匹林耐药性与TE事件的频率增加有显著的关联 (HR 2.66).
- 在中脑动脉和脊椎骨干系统的大血管封闭方面,发病率很高.
结论:
- 在FD后发生的TE事件是多因素的,受患者年龄,动脉瘤特征,位置,抗血小板抵抗和程序因素的影响.
- 抗阿司匹林耐药性是流量转移后TE事件的重要预测因素.
- 特定的位置,如中脑动脉和脊柱系统携带更高的TE事件的发病风险.
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