脑血管的内血管治疗结果在低度的神经瘤下arachnoid出血中
Rami Fakih1,2, Ibrahim A Bhatti1,2,3, Rehan Ahmed1
1Zeenat Qureshi Stroke Institutes, Columbia, Missouri, USA.
概括
内血管治疗 (EVT) 显著改善了严重动脉瘤下关节出血 (aSAH) 和血管的患者的治疗结果. 这种治疗与这个高危人群的更好的功能状态和生存率有关.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 干预性放射学 干预性放射学
背景情况:
- 动脉瘤下关节出血 (aSAH) 是一个危急的情况.
- 对于WFNS等级≥4aSAH与血管的结局通常很差.
- 内血管治疗 (EVT) 在这个子组中的作用还不清楚.
研究的目的:
- 评估EVT对功能结果和生存的影响.
- 评估EVT与严重aSAH和血管患者的结局之间的关联.
- 在高风险的神经病患者群体中调查EVT的益处.
主要方法:
- 对80名患有WFNS等级≥4aSAH和血管的患者进行了回顾性队列研究.
- EVT包括动脉内血管扩张剂和/或气球血管整形.
- 主要结局:在90天后的良好功能状态 (mRS 0-3);使用多变量逻辑回归分析.
主要成果:
- 77.5%的患者接受了EVT治疗.
- 在EVT组中,有利的结果更频繁 (48.4%对22.2%,p=0.038).
- EVT独立预测了有利的结果 (aOR 3.15) 和降低死亡率 (aOR 0.24). 早期治疗 (≤12小时) 也改善了结果.
结论:
- 在低度aSAH患者中,EVT独立地与改善的功能结果和生存相关,患者有血管.
- 研究结果支持对这种高风险人群进行及时,积极的内血管干预.
- EVT挑战了关于严重aSAH的结果的历史悲观主义.
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