神经内血管治疗中抗血栓治疗的现实数据:JR-NET 4的分析
Nozomi Sasaki1, Yukiko Enomoto1, Hiroshi Yamagami2
1Department of Neurosurgery, Gifu University Graduate School of Medicine.
Neurologia medico-chirurgica
|October 23, 2024
概括
周围手术双抗血小板治疗 (DAPT) 在日本神经内血管手术中越来越常见. 肝素的使用减少,而缺血性并发症略有增加,三重治疗组的风险更高.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 医疗技术 医疗技术 医学技术
背景情况:
- 神经内血管疗法在日本正在扩大.
- 了解当前的抗血栓策略对于患者安全和程序结果至关重要.
- 之前的注册表数据 (JR-NET 2和3) 提供了一个基线进行比较.
研究的目的:
- 分析日本神经内血管手术周边手术抗血栓治疗的趋势.
- 将当前的做法与JR-NET 2和3的历史数据进行比较.
- 评估抗血栓策略与周围手术并发症之间的关联.
主要方法:
- 日本神经内血管治疗注册 (JR-NET) 4数据库 (2015-2019) 的回顾性分析.
- 收集了针对脑动脉瘤和血管塑造/支架的抗血栓治疗的数据.
- 将JR-NET 4数据与JR-NET 2 (2008-2009) 和JR-NET 3 (2010-2014) 的数据进行比较.
主要成果:
- 在手术前的双抗血小板治疗 (DAPT) 从48.1% (JR-NET 2) 显著增加到62.3% (JR-NET 4).
- 单疗法和术后抗凝剂 (肝素) 的使用显著下降.
- 缺血性并发症略有增加 (5.8%至6.2%),在三重治疗组中,严重不良事件的发生率更高.
结论:
- 围绕程序的双重抗血小板治疗 (DAPT) 已成为日本神经内血管治疗中占主导地位的抗血小板治疗策略.
- 肝素使用量的下降和DAPT使用量的增加要求继续监测并发症率.
- 三次或更多的抗血栓治疗与严重不良事件的增加有关.
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