最近的随机MeVO试验对当前实践模式和MeVO血栓切除术未来作用的影响
Salome Lou Bosshart1, Yu Zhou2, Alexander Stebner3
1Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland.
概括
医生认为,尽管试验结果中立,内血管血栓切除术 (EVT) 对精选的中血管封闭 (MeVO) 中风患者有好处. 大多数人愿意加入未来的MeVO-EVT试验,辅助血栓溶解被视为关键.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 非随机化研究表明,内血管血栓切除术 (EVT) 有益于中等血管封闭 (MeVO) 卒中.
- 最近的随机试验报告了MeVO中EVT的中性结果,导致异质的临床实践.
- 医生对MeVO管理和未来试验设计的看法对于指导治疗策略至关重要.
研究的目的:
- 评估内血管MeVO管理的当前实践模式.
- 了解医生对最近MeVO试验影响的看法.
- 测量参与未来MeVO-EVT试验的意愿,并确定最佳治疗策略.
主要方法:
- 在医生中进行了一项国际性的横截面调查.
- 该调查询问了MeVO试验前后的实践模式,试验设计的意见和治疗策略.
- 描述性统计数据被用来总结来自456名医生的匿名回复.
主要成果:
- 18.9%的人在试验后用EVT治疗了更多的MeVOs,而29.5%的人治疗了更少的MeVOs.
- 91.6%的人同样或更愿意将患者纳入第二代MeVO-EVT试验.
- 68.7%的人认为EVT对选择的MeVO患者有好处,理由是之前的试验中招募偏差; 63.9%预计辅助性动脉内血栓溶解将发挥重要作用.
结论:
- 大多数医生坚持认为,EVT对精选的MeVO患者有益.
- 招生偏见被确定为中立试验结果的潜在原因.
- 对于未来的MeVO-EVT试验存在很高的意愿,辅助血栓溶解被认为是未来的关键战略.
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