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内血管血栓切除术与大血管中风和传染性内心炎患者的医疗管理相比

Huanwen Chen^1,2, Marco Colasurdo³, Mihir Khunte⁴

¹National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.

Journal of neurointerventional surgery

|September 24, 2024

概括

血管内血栓切除术 (EVT) 与医疗管理相比,在感染性内心炎 (IE) 患者中改善大血管封闭 (LVO) 中风的结果. EVT提供了更高的例行家庭出院率和更低的住院死亡率.

科学领域:

神经学神经学
心脏病学心脏病学
干预性放射学干预性放射学

背景情况:

血管内血栓切除术 (EVT) 对于感染性内心炎 (IE) 患者的大血管封闭 (LVO) 中风的疗效尚不清楚.
与医疗管理 (MM) 的比较对于指导治疗决策至关重要.

研究的目的:

为了比较EVT与MM对IE患者LVO中风的安全性和有效性.
评估关键的住院结果,包括出院处置,死亡率和出血率.

主要方法:

全国对美国住院病人的分析.
倾向性得分匹配 (PSM) 和双重可靠的分析被用于调整混因素.
主要结局:以自我照顾为例的家庭出院. 二次结局:在家出院,住院死亡率,脑内出血 (ICH) 和脑下出血 (SAH).

主要成果:

与MM相比,EVT与常规家庭出院率 (14.6%与8.5%) 和整体家庭出院率 (34.5%与26.5%) 的显著增加有关.
接受EVT的患者在医院内死亡率 (14.8%vs25.2%) 和ICH率 (15.8%vs23.1%) 显著降低.
在EVT和MM组之间没有观察到SAH率的显著差异.

结论:

在LVO中风和IE患者中,EVT与改善住院结果有关.
与MM相比,EVT表现出有利的安全概况,与MM相比,ICH的发生率较低.
这些发现支持在一些LVO中风和IE患者中考虑EVT.

关键词:

发生出血发生出血感染感染感染一次性中风,中风.进行血栓切除术 (thrombectomy).血栓溶解是一种血栓溶解.

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