与肺动脉静脉形形相关的缺血性中风:两个病例报告和一篇文学评论
Gabriel García-Alcántara1, Rocío Vera-Lechuga1, Beatriz Martínez-García1
1Department of Neurology and Stroke Unit.
The neurologist
|October 30, 2025
概括
肺动脉静脉形形 (PAVMs) 可以通过悖论性栓塞引起缺血性中风. 栓塞是PAVMs的首选治疗方法,其次是预防中风的抗血小板治疗.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 肺动脉静脉形形 (PAVM) 很少与缺血性中风有关.
- PAVMs通常会导致中等 (MeVOs) 和远端血管封闭 (DVOs),而不是大血管封闭 (LVOs).
- 孤立的PAVM可以导致悖论性栓塞,导致中风风险.
研究的目的:
- 为了呈现与PAVMs相关的缺血性中风的临床病例.
- 突出导致中风的PAVM的诊断和治疗策略.
- 强调栓塞和抗血小板治疗在治疗这些疾病中的作用.
主要方法:
- 两名患有缺血性中风和PAVM的患者的病例报告.
- 诊断工具包括通过皮多普勒 (TCD) 进行泡测试和通过食道的心声回声 (TEE).
- 肺部计算机断层扫描血管图 (CTPA) 证实了PAVMs,随后进行了栓塞治疗.
主要成果:
- 一名患者因MeVO而患上中风,并通过静脉输血栓溶解 (IVT) 成功治疗.
- 在这两位患者中,TEE排除了卵孔 (PFO) 的专利.
- 经验证实了PAVM,并通过栓塞成功治疗,在随访期间没有复发性缺血事件.
结论:
- PAVMs是缺血性中风的不常见但重要的原因.
- 栓塞是导致中风的PAVM的主要治疗方法.
- 建议在栓塞后进行抗血小板治疗,在特定情况下考虑抗凝药.
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