冠状动脉网:病理生理学,诊断和治疗选择. 一个叙事审查
Emeraude Rivoire1,2, Nellie Della Schiava1,3, Olivier Rouvière4,5
1Service de Chirurgie Vasculaire et Endovasculaire, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France.
Vascular medicine (London, England)
|October 14, 2024
概括
动脉网 (CaWeb) 是年轻人中风的未被确诊的原因,通常被传统的狭窄标准遗漏. 治疗正在发展,Endarterectomy或支架成为症状病例的第一线治疗方法.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- 頸動脈網 (CaWeb),或頸動脈球膜,是一種纖維的內臟刺激,引起缺血性中風,尤其是在年輕人.
- CaWebs的诊断不足,并且在双重超声检查中频繁存在不到50%的狭窄,使诊断复杂化.
- 来自内血栓的动脉动脉栓塞是CaWeb患者中风的关键机制.
研究的目的:
- 提供关于动脉网 (CaWebs) 的最新评论.
- 为了突出最近在CaWebs的诊断和管理方面的进展.
- 为了解决管理症状和无症状CaWebs的复杂性.
主要方法:
- 在主要电子数据库 (MEDLINE/PubMed,Cochrane Library,Web of Science,EMBASE) 进行全面的文献搜索,截至2024年2月13日.
- 包含最近关于动脉疾病和中风管理的指南,特别是针对CaWebs.
- 对CaWebs的诊断方式和治疗策略的分析.
主要成果:
- 在患有严重前脑卒中的年轻患者中,高达10%的人,特别是年轻女性中,发现了动脉网.
- 计算机断层扫描血管造影是主要的诊断工具,因为双重超声波通常显示最小的狭窄.
- 抗血栓治疗显示出高的中风复发率;对症状的CaWebs来说,越来越喜欢切除关节或支架.
结论:
- 冠状动脉网是年轻患者中风的重要原因,由于狭窄度较低,经常被忽视.
- 目前对CaWebs的管理指南有限且不断发展,导致复杂的临床决策.
- 需要从多中心注册处获得进一步的数据,以指导对症状和无症状CaWebs的最佳管理策略.
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