血栓切除术医院间转移期间的出血转变:发生率,相关因素和与结果的关系
Pierre Seners1,2,3, Adrien Ter Schiphorst2,3,4, Anke Wouters3,5
1Neurology Department, Hôpital Fondation A. de Rothschild, Paris, France.
European stroke journal
|June 27, 2025
概括
在急性缺血性中风与大血管封闭 (AIS-LVO) 转移期间的出血转变 (HT) 是不常见的,但与糟糕的结果有关. 进一步研究降低HT风险是有必要的.
科学领域:
- 神经学 神经学
- 干预性神经放射学 干预性神经放射学
- 脑卒中医学 脑卒中医学
背景情况:
- 患有大血管封闭性急性缺血性中风 (AIS-LVO) 的患者经常在初级和综合性中风中心之间进行内血管治疗 (EVT).
- 在这种医院间转移期间,出血转变 (HT) 是一个潜在的并发症.
- 影响HT的因素及其对患者结果的影响需要调查.
研究的目的:
- 为了确定AIS-LVO的医院间转移期间HT的发生率.
- 为了确定转移期间与HT相关的因素.
- 评估HT和3个月功能结果之间的关系.
主要方法:
- 对从EVT初级中风中心转移到综合性中风中心的AIS-LVO患者的回顾性分析.
- 包括标准:前部循环AIS-LVO,转移前成像和CSC到达成像.
- 在CSC成像中,HT被定义为新出现的对瘤出血;扩张被定义为体积增加.
主要成果:
- 5.5%的患者 (31/566) 在转移期间经历了HT.
- 与动脉再通道化,较高的NIHSS和较长的症状发作到CSC到达时间相关的HT.
- 在24%的HT病例中出现了HT扩张;HT与3个月的不良结果 (mRS ≥3) 有关.
结论:
- 在用于EVT的医院间转移期间的HT不常见,但显著.
- HT与随后的扩张和3个月后更糟糕的功能结果有关.
- 应考虑在转移期间减轻HT风险的策略.
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