在中脑膜动脉栓塞后进行抗血栓治疗的安全性
Rahul K Chaliparambil1, Mykhaylo Krushelnytskyy1, Khizar R Nandoliya1
1Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago , Illinois , USA.
Neurosurgery
|September 27, 2024
概括
在中脑膜动脉栓塞 (MMAE) 后,在慢性下皮质血瘤 (cSDH) 解决之前重新开始抗血栓治疗与更低的放射分辨率有关. 建议在MMAE后需要恢复治疗的患者谨慎地恢复AT治疗.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 血管栓塞是因为血管栓塞.
背景情况:
- 中脑膜动脉栓塞 (MMAE) 是一种治疗慢性脑下血液瘤 (cSDH) 的方法.
- 对于MMAE后的患者,重新开始抗血栓治疗 (AT) 往往是必要的.
- 早期恢复AT治疗对MMAE后cSDH解析的影响尚不清楚.
研究的目的:
- 评估在cSDH解决之前重新开始AT治疗对MMAE后放射和临床结果的影响.
- 为了确定AT治疗恢复的时间是否会影响cSDH分辨率.
主要方法:
- 在2018年至2024年间对111名接受MMAE的患者进行了回顾性研究.
- 对临床和放射性发现的分析,比较恢复AT治疗的患者与没有恢复的患者.
- 卡普兰-梅尔曲线用于评估基于AT恢复时间的非解决率.
主要成果:
- 41.4%的患者实现了完全cSDH解脱;9.9%需要重新手术.
- 在cSDH分辨率之前恢复AT治疗的患者显著降低了放射性分辨率 (21.9%与49.4%相比).
- 恢复率和残留症状呈现在各组之间是可比的;AT恢复的时间 (在30天前和30天后) 并没有显著影响结果.
结论:
- 在MMAE后cSDH解析之前重新启动AT治疗与放射性分辨率降低有关.
- 重复手术和残留症状的发生率相似,不管AT治疗的恢复时间如何.
- 建议在MMAE后需要AT治疗的患者谨慎重新开始治疗.
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