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在基底动脉封闭时进行再输血治疗,呈现轻度症状

Ghil Schwarz¹, Angelo Cascio Rizzo¹, Marius Matusevicius^2,3

¹Department of Neurology and Stroke Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

European stroke journal

|August 20, 2024

概括

内血管治疗 (EVT) 加上IVT对于轻度基底动脉封闭 (BAO) 症状 (NIHSS 0-10) 没有比单独IVT的好处. 对于非常轻度的BAO (NIHSS 0-5),单独IVT的结果比EVT加IVT的结果更好.

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:

内血管治疗 (EVT) 对中度至重度的基础动脉封闭 (BAO) 有效.
对轻度BAO症状 (NIHSS 0-10和0-5) 的最佳治疗仍然不确定.
这项研究调查了轻度BAO患者的EVT加IVT和单独IVT.

研究的目的:

为了比较EVT±IVT与IVT单独用于轻度BAO的疗效和安全性.
根据不同的NIHSS得分范围 (0-10和0-5) 分析结果.

主要方法:

对SITS-国际中风治疗注册 (2013-2021) 的回顾性分析.
包括在6小时内治疗的BAO患者.
使用双强强的方法 (倾向性得分匹配和后勤回归) 进行分析.

主要成果:

对于NIHSS 0-10 (180匹配对),结果在单独使用EVT±IVT和IVT之间是相似的.
对于NIHSS 0-5 (89个匹配对),EVT ± IVT与更糟糕的结果有关 (mRS 0-2:aOR 0.20;mRS 0-3:aOR 0.27).
安全结果 (SICH,3个月死亡) 在两组之间是可比的.

结论:

与单独IVT相比,EVT±IVT在NIHSS 0-10的早期接受BAO治疗的患者中没有显著的结果差异.
对于非常轻度的BAO (NIHSS 0-5),单独IVT与EVT±IVT相比显示出更好的结果.
随机试验对于确定轻度BAO的最佳再输注策略至关重要.

关键词:

基底动脉的闭塞基础动脉的闭塞缺血性中风中风轻微的症状症状轻微的症状

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