单独或与静脉血栓溶解一起进行血栓切除术,用于管理由基底动脉阻塞引起的急性缺血性中风:一项多中心观察性研究
Mo Yang1, Yue-Zhou Cao1, Peng-Hua Lv2
1From the Department of Interventional Radiology (M.Y., Y.-Z.C., Z.J., L.-B.Z., H.-B.S, S.L.), The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
AJNR. American journal of neuroradiology
|September 30, 2024
概括
直接内血管治疗 (DEVT) 和桥梁治疗 (静脉血栓溶解加EVT) 在急性基底动脉闭塞中风中显示出类似的功能结果. 桥梁疗法减少了血栓切除术的尝试.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 脑卒中医学 脑卒中医学
背景情况:
- 从基底动脉封闭 (BAO) 引起的急性缺血性中风 (AIS) 带来了重大挑战.
- 将直接内血管治疗 (DEVT) 与桥梁治疗 (静脉血栓溶解 (IVT) 加EVT) 进行比较的最佳治疗策略仍在争论中.
研究的目的:
- 为了比较DEVT与急性BAO的桥梁治疗之间的功能结果,在症状出现后4.5小时内.
- 评估二次结果,包括再输血率,症状性内出血和死亡率.
主要方法:
- 在4.5小时内对153名急性BAO患者进行多中心回顾性队列研究.
- 患者被分为DEVT (n=65) 和桥梁治疗 (n=88) 组.
- 主要结局:在90天后具有良好的功能结局 (修改的兰金尺度0-3).
主要成果:
- 90天后的功能结果相似:DEVT中的44.6%,桥梁治疗中的39.8% (P=.753).
- 桥梁治疗组需要更少的血栓切除术尝试 (≥3次尝试:aOR 0.39,P=.034).
- 在再输血率,症状性内出血或死亡率上没有显著差异.
结论:
- 直接内血管治疗提供了与4.5小时内急性BAO中风的桥梁治疗相似的功能结果.
- 作为桥梁治疗的一部分,静脉内血栓溶解可以减少血栓切除手术的复杂性.
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