状持续性动脉静脉的内血管治疗:一项回顾性单中心研究
Guanghao Zhang1, Miao Pang1, Zhe Li1
1Department of Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
AJNR. American journal of neuroradiology
|January 29, 2025
概括
血管内治疗是一种安全有效的第一线治疗,用于长期动脉静脉 (TDAVFs),实现高闭塞率和良好的功能结果. 超动脉栓塞,主要通过中脑膜动脉,是主要的治疗方法.
科学领域:
- 神经学 神经学
- 干预性放射学 干预性放射学
- 神经外科 神经外科
背景情况:
- 长脉动静脉 (TDAVFs) 是一种复杂的血管形.
- 内血管治疗 (EVT) 越来越多地被认为是治疗TDAVF的有效性和安全性.
- 了解一线EVT的临床和血管检查结果对于治疗规划至关重要.
研究的目的:
- 评估内血管治疗 (EVT) 的临床和血管学结果,作为长脉动静脉 (TDAVFs) 的第一线治疗.
- 为了确定脑内出血,手术相关并发症和TDAVF患者功能表现不佳的预测因素.
主要方法:
- 从2009年4月到2023年11月,对83名TDAVF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,临床表现,治疗细节和随访结果.
- 进行了单变量和多变量逻辑回归分析,以确定结果预测因素.
主要成果:
- 高立即封闭率 (89.1%) 和持续封闭在6个月的随访 (91.2%) 实现了EVT.
- 在临床随访期间,在89.1%的患者中观察到有利的功能结局 (mRS 0-2).
- 深静脉排水和中线位置与较低的内出血发生率有关;基线mRS 3-5预测了功能不良的结果.
结论:
- 血管内治疗是TDAVF的安全有效的初级疗法,产生高阻塞和有利的功能结果.
- 超动脉栓塞,主要通过中脑膜动脉,是治疗的主要支柱.
- 在使用大动脉养器的情况下,省略激进栓塞并没有影响疗效或增加并发症.
相关概念视频
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...