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对于患有先前存在残疾的患者的大血管封闭性中风的内血管血栓切除术
Sai Polineni1, Amol Mehta1, Lisa Ramirez2
1Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Journal of neurointerventional surgery
|April 4, 2025
概括
血管内血栓切除术 (EVT) 是安全有效的急性缺血性中风患者以前的残疾. 许多患者在治疗后90天内恢复了病前的功能状态.
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:
- 在急性缺血性中风 (AIS) 患者中,很大一部分患者有先前存在的残疾.
- 这些患者经常被排除在临床试验之外,导致他们的治疗结果不清楚.
- 现有的文献缺乏关于EVT在这个人群中的安全性和有效性的明确性.
研究的目的:
- 评估内血管血栓切除术 (EVT) 在急性缺血性中风 (AIS) 患者的安全性和有效性.
- 为了比较EVT在患有和没有基线残疾的患者的结果.
主要方法:
- 查询了从2014年12月到2023年10月接受EVT的AIS患者的注册表.
- 患者根据修改的兰金尺度 (mRS) 评分 (0-1比2-5) 进行分层,以定义基线残疾.
- 用单变量和多变量回归分析来比较人口和临床结果.
主要成果:
- 在1489名患者中,367名 (24.6%) 患有基线残疾;他们年龄较大,女性更常见,并具有更多的中风风险因素.
- 患有基线残疾的患者在EVT后显着更高的回归到病前功能状态 (90天 ΔmRS ≤ 0 或 ≤ 1) 的几率.
- 在基线残疾组中没有观察到症状性脑内出血或90天死亡率的显著增加.
结论:
- 内血管血栓切除术 (EVT) 是一种安全有效的治疗急性缺血性中风患者的安全和有效治疗方法.
- 在许多残疾患者中,EVT可以在90天内使其恢复到患病前的功能状态.
- 这些发现支持考虑为AIS患者提供EVT,无论其基线功能状态如何.
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