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基础动脉阻塞中风的内血管治疗常规与高级成像选择

Huanwen Chen^1,2, Marco Colasurdo³, Hidetoshi Matsukawa⁴

¹National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.

European stroke journal

|August 28, 2025

概括

传统的成像足以为基础动脉封闭内血管血栓切除 (EVT) 选择患者. 先进的成像在这个患者群体中没有改善结果,使传统方法成为实际的第一线选择.

科学领域:

神经学
干预性放射学
脑卒中医学

背景情况:

血管内血栓切除术 (EVT) 是基础动脉阻塞中风的关键治疗方法.
与传统成像 (非对比CT,CT血管造影) 相比,对于 BAO EVT 患者选择的高级成像 (CT perfusion,MR) 的必要性仍然不清楚.

研究的目的:

在选择患者接受 BAO EVT 时,先进成像与传统成像的有效性进行比较.
确定高级成像是否改善了BAO EVT患者的临床结果.

主要方法:

一项多中心回顾性队列研究分析了从2013年至2022年的BAO EVT患者.
使用倾向性得分匹配 (PSM) 来比较通过高级成像 (CTP或MR) 选择的患者与通过传统成像选择的患者.
主要结局是90天后的功能独立性;次要结局包括死亡率和症状性内出血 (sICH).

主要成果:

包括268名患者; 150名通过常规成像和118名通过高级成像.
在PSM后,在90天的功能独立性,卧床状态或死亡率或sICH之间没有显著差异.
两种成像方法的不同治疗时间窗口的结果仍然相似.

结论:

使用常规成像来选择基底动脉EVT的患者,其临床结果与高级成像相似.
在临床实践中,传统的成像是BAO EVT的第一线选择工具.
无论使用哪种成像方法,都没有发现功能独立性或安全性结果的显著差异.

关键词:

一个方面基本的计算机断层扫描发生出血进行成像磁共振输液方式一次中风血栓切除术时间窗口

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