脑中风的内血管治疗由于中等或远端血管的封闭导致的中风
Marios Psychogios1,2, Alex Brehm1, Marc Ribo3,4
1Department of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, Switzerland.
The New England journal of medicine
|February 5, 2025
概括
与单独的最佳医疗治疗相比,对中等或远端血管阻塞中风的内血管治疗 (EVT) 并没有减少残疾. 该研究发现,这两组人之间在结局或死亡率上没有显著差异.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 内血管治疗 (EVT) 已被确立为大血管阻塞中风的安全和有效治疗.
- 对于EVT对中等或远端血管封闭的疗效仍然不确定.
研究的目的:
- 为了评估EVT在患有孤立的中等或远端血管闭塞的患者中的有效性.
- 为了比较EVT加最佳医疗治疗和单独最佳医疗治疗之间的功能结果和死亡率.
主要方法:
- 随机对照试验涉及543名参与者,他们有孤立的中等或远端血管封闭.
- 参与者被分配到EVT加最佳医疗治疗或仅在24小时内获得最佳医疗治疗.
- 主要结局是90天后修改后的兰金度量得分.
主要成果:
- 在EVT和单独最佳医疗治疗组之间,90天后修改的兰金度数没有显著差异 (改善的常见几率比,0.90;P=0.50).
- 所有原因的死亡率相似:在EVT组中15.5%,仅在最佳医疗治疗组中为14.0%.
- 症状性内出血的发生率为EVT的5.9%,单独最佳医疗治疗的2.6%.
结论:
- 与单独的最佳医疗治疗相比,EVT并没有导致中等或远端血管封闭性中风患者的残疾水平降低.
- 在这个患者群体中,EVT并没有降低死亡的发生率.
- 这些发现表明,EVT可能对孤立的中端或远端血管封闭不有益.
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