六分之一的患者在中风机械血栓切除过程中在10分钟的重复脑血管造影中表现出反变化
Jackson P Midtlien1, Omar Ashraf2, Ferdinand K Hui3
1Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA jmidtlie@wakehealth.edu.
Journal of neurointerventional surgery
|November 29, 2024
概括
血管内血栓切除术后目标血管的重新封闭是常见的,影响6分之一的患者. 早期评估和干预对于改善中风患者的治疗结果至关重要.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 血管外科 血管外科
背景情况:
- 在内静脉血栓切除术 (EVT) 后,重建后目标血管再封闭 (TVR) 是已知的并发症.
- 在中风患者中,TVR与更糟糕的长期功能结果有关.
- 在EVT之后立即出现TVR的发生率和促成因素尚不清楚.
研究的目的:
- 为了前性地评估TVR在EVT之后的直接时间框架中的发生率.
- 评估TVR对功能结果的影响.
- 为了确定早期EVT后血管造影评估的有用性.
主要方法:
- 一项前性多中心研究,涉及成年患者接受EVT治疗急性大血管封闭.
- 在脑梗塞中修改型血栓溶解 (TICI) 分数在EVT结束时和10分钟后被记录下来.
- 评估TVR和转血状态的变化.
主要成果:
- 16.2%的患者在EVT后10分钟内经历了TICI得分的变化,70%的患者表现出恶化.
- 13%的患者的术后护理发生了变化,8%的患者由于再输变化而接受了进一步的干预.
- 在90天后,TICI得分较差的患者 (21%) 的功能独立性低于整个队列 (31%) 的患者.
结论:
- 这是第一个评估EVT后即时TVR的前性研究.
- 很大一部分患者 (6人中1人) 经历了TVR,在某些情况下需要进行干预.
- 在EVT后10分钟进行例行血管图形评估应由神经干预医生考虑.
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