脑外脊椎动脉狭窄的内血管管理
Huanwen Chen1, Marco Colasurdo2, Matias Luis Costa3
1Neurology, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
Journal of neurointerventional surgery
|February 8, 2025
概括
额外椎动脉狭窄是后部循环缺血性中风的研究不足的原因. 本综述检查了内血管支架和先进的成像,以管理这种情况,并改善中风风险分层.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 后循环缺血性中风约占所有缺血性中风的20%.
- 脊椎骨系统是后部循环的主要供应者.
- 与内病理相比,额外椎动脉狭窄是未被充分研究的中风原因.
研究的目的:
- 审查有关脑外脊椎动脉疾病的当前数据.
- 专注于内血管支架在管理额外椎动脉狭窄症中的作用.
- 讨论关于中风风险分层和患者选择的高级成像.
主要方法:
- 对回顾性,前性和随机化试验数据的叙述性审查.
- 专注于内血管支架干预措施.
- 讨论先进的成像技术,包括定量磁共振血管学.
主要成果:
- 额外椎动脉狭窄是一个重要的,但尚未研究的,导致后部循环中风的因素.
- 血管内静脉支架在治疗症状性脑外脊椎动脉狭窄症方面表现有前途.
- 定量磁共振血管学有助于风险分层和选择患者进行干预.
结论:
- 需要进一步的研究,以充分阐明干预额外椎动脉狭窄的风险和益处.
- 血管内静脉支架是一种可行的选择,可以选择患有症状的脑外脊椎动脉狭窄症的患者.
- 先进的成像在优化患者选择和管理策略方面发挥着至关重要的作用.
相关概念视频
Mitral 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...
Aortic 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...
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...


