在急性中风内血管治疗后早期的神经系统恶化,症状轻微
Satoru Fujiwara1, Kazutaka Uchida2, Tsuyoshi Ohta1
1Kobe City Medical Center General Hospital, Kobe, Japan.
Neuroradiology
|April 14, 2025
概括
对于轻度急性缺血性中风 (AIS) 的内血管治疗 (EVT) 后的早期神经系统恶化 (END) 是常见的,并且与糟糕的结果有关. 风险分层对于这些患者至关重要.
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) 是急性缺血性中风 (AIS) 的关键疗法.
- 在轻度AIS症状 (NIHSS分数≤5) 的患者中,存在对EVT后早期神经系统恶化 (END) 的担忧.
- 在这个特定的患者群体中,END的预后意义和特征需要进一步调查.
研究的目的:
- 为了研究急性缺血性中风 (AIS) 和轻度症状的患者在EVT后早期神经病变 (END) 的预后影响.
- 为了确定该患者群体中与END相关的特征和风险因素.
主要方法:
- 对日本神经内血管治疗注册4数据库进行了后期分析.
- 包括503名患有AIS和NIHSS得分≤5的患者,他们在2015年至2019年期间接受了EVT.
- 结局 (30天的mRS) 患者和没有END患者之间的结果进行了比较;多变量逻辑回归确定了END的风险因素.
主要成果:
- 在接受EVT的13% (66/503) 轻度AIS患者中发生了早期神经系统恶化 (END).
- 患有END的患者的30天功能结果明显恶化 (mRS 0-2:17%vs. 80%) 和30天死亡率更高 (9.1%vs. 0.7%).
- END的危险因素包括75岁以上的年龄,较低的ASPECTS分数,NIHSS分数为0-2 (vs. 3-5),以及未成功的再道化.
结论:
- 早期神经系统恶化 (END) 是轻度AIS的EVT后的显著并发症,与功能表现不佳和死亡率增加有关.
- 对END的风险分层是必不可少的,特别是对于有轻度中风症状的EVT候选人.
- 提高再道化率可能对减轻END风险至关重要.
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