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晚期神经事件在无症状和有症状的隔离下关节窃取中

Ali F AbuRahma¹, Christina Veith¹, Noah Dargy¹

¹Department of Surgery, Charleston Area Medical Center/West Virginia University, Charleston, 3200 MacCorkle Ave, SE, Charleston, WV 25304.

Journal of vascular surgery

|May 10, 2025

概括

关节下窃取 (SS) 是罕见的,通常无症状. 隔离的SS表明良性自然史,在诊断后长达五年的患者中没有观察到后部循环中风.

科学领域:

血管外科血管外科
神经学神经学
诊断成像诊断成像诊断成像

背景情况:

关节下盗窃 (SS) 是一种血液在脊椎动脉中向后流动的情况,可能会危及大脑输液.
孤立SS的自然史和长期神经结果,特别是无症状与症状患者的自然史和长期神经结果,需要进一步阐明.

研究的目的:

分析患有无症状或有症状的隔离性下骨窃取 (SS) 患者的长期神经事件.
为了确定5年内孤立SS患者晚期神经事件的发生率和特征.
为了比较孤立的SS的结果与与显著的动脉疾病相关的SS的结果.

主要方法:

两年来对11,762次心室双重超声检查 (CDUE) 进行了回顾性分析,以确定SS.
记录晚期的神经事件,包括过渡性缺血性攻击/中风,对于孤立的SS (没有相关的动脉疾病).
卡普兰-梅尔分析进行,以评估孤立的有症状的SS,孤立的无症状的SS,以及结合SS和心血管疾病的患者中风的自由.

主要成果:

检测到285个SS病例 (2%的患病率);115个 (40%) 有孤立的SS,而60%与>70%的动脉狭窄有关.
在孤立的SS患者中 (85无症状,30有症状),无症状组中发生了一次过渡性缺血性发作和两次晚期中风 (既没有后部循环中风);在症状组中没有发生中风.
卡普兰-梅尔分析显示,在5年内,中风的发病率很高 (97%的整个系列,96%的无症状隔离SS,100%的症状隔离SS).

结论:

在常规的冠状动脉双重超声检查中检测到的甲骨架下窃取 (SS) 是不常见的.
孤立的SS,无论最初的症状状况如何,都表现出有利的长期预后,中风风险低,特别是在后部循环中.
这些发现支持对无症状孤立SS的保守管理方法.

关键词:

临床结果临床结果神经事件神经事件关节骨下部的窃取窃取

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