门内,环内和内MAC手术后的抗血栓治疗:系统性审查和元分析
Gonçalo Terleira Batista1, Gonçalo Costa2, Joana Delgado Silva2
1Serviço de Cardiologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
Acta medica portuguesa
|July 21, 2025
概括
抗凝药可以减少门内,门环内和门中环状化手术后的门血栓形成. 由于对出血和死亡率的数据有限,需要进一步研究.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物材料科学 生物材料科学
背景情况:
- 有限的证据存在于最佳的抗血栓治疗后的门在门 (ViV),门在环 (ViR) 和门在心膜环状化 (ViMAC) 程序.
- 在ViV干预中观察到的血栓形成风险增加需要进一步调查.
- 目前的抗血栓策略需要优化这些特定的跨导管程序.
研究的目的:
- 在ViV,ViR和ViMAC程序中系统地审查抗凝治疗与抗血小板治疗的潜在益处.
- 在接受这些干预的患者中评估不同抗血栓策略的有效性和安全性.
- 为了确定当前关于复杂的门干预的抗血栓管理的研究中的差距.
主要方法:
- 系统地搜索PubMed,Embase,Cochrane中央注册表和灰色文献,直到2023年12月.
- 包括观察和干预研究,对抗血栓策略进行比较分析.
- 主要终点:临床和全血栓 (VT);安全终点:严重出血. 对双肩位置和门类型的分析.
主要成果:
- 包括五项观察性研究和一个案例系列 (1082名参与者).
- 与抗血小板药物相比,抗凝血与显著较低的临床VT (1.1%与8.3%) 和总VT (1.3%与8.5%) 率相关.
- 关于出血事件的数据不足以进行彻底分析.
结论:
- 抗凝血疗法在ViV,ViR和ViMAC手术后降低高膜血栓发生率方面显示出潜在的益处.
- 由于缺乏随机对照试验和全面的出血/死亡数据,需要进一步调查.
- 未来的研究应该集中在随机试验上,以建立最佳的抗血栓策略和安全概况.
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