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在急性缺血性中风中,在内血管治疗后进行虚假的再通道化,具有大的缺血核心

Hyunsoo Kim¹, Joon-Tae Kim¹, Kang-Ho Choi¹

¹Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebongro, Dong-gu, Gwangju, 61469, Korea.

|October 16, 2024

概括

对于急性缺血性中风 (AIS) 的内血管治疗 (EVT) 后的虚性再通道 (FR) 与年龄更大和初始中风严重程度更高有关. 不接受静脉血栓溶解会增加患有大核心心脏病发作的患者FR的风险.

科学领域:

神经学神经学
干预性放射学干预性放射学
脑卒中医学脑卒中医学

背景情况:

内血管治疗 (EVT) 是急性缺血性中风 (AIS) 的主要治疗方法,主要用于大血管封闭.
虚空再通道 (FR),在成功的EVT没有导致临床改善的情况下,是一个重大挑战.
在大心脏梗塞 (LCI) 的AIS中确定与FR相关的因素对于优化治疗结果至关重要.

研究的目的:

确定与AIS和大核心心脏病发作 (LCI) 患者无效再通道化 (FR) 相关的中风风险因素和患者特征.
分析该患者队列中EVT后FR的独立预测因子.

主要方法:

对137名患有AIS和LCI (DWI-ASPECT<6) 的患者进行了回顾性分析,这些患者接受了EVT治疗.
收集的数据包括人口统计,中风严重程度 (NIHSS),治疗时间和之前的干预措施.
在90天后,FR被定义为成功的再输血 (mTICI ≥2b) 没有功能独立 (mRS ≥3). 使用了多变量逻辑回归.

主要成果:

在120名患者中成功实现了再通道化.
80名患者经历了FR,而40人没有.
FR的独立预测因素包括年龄较大 (OR 1.052),较高的NIHSS初始得分 (OR 1.181) 和没有先前的静脉血栓溶解 (OR 0.310).

结论:

年龄较大,NIHSS初始得分较高,以及不接受静脉血栓溶解,独立地与LCI的AIS中徒劳的再通道化有关.
这些已识别的因素可以帮助预测对EVT反应不佳的患者,指导临床决策.

关键词:

急性缺血性中风是一次急性缺血性中风.血管内治疗血管内治疗毫无意义的重新道化大的缺血性核心.

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