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内血管治疗与基底动脉封闭的医疗管理,超过24小时的表现

Chunrong Tao¹, Teng Hu², Zhongjun Chen²

¹Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Rd, Luyang District, Hefei City, Anhui Province, 230036 China.

|January 13, 2026

概括

基底动脉阻塞 (BAO) 中风的内血管治疗 (EVT) 超过24小时改善了功能结果,但增加了出血风险. 这项研究强调了EVT.

科学领域:

神经学神经学
干预性放射学干预性放射学
脑卒中医学脑卒中医学

背景情况:

血管内治疗 (EVT) 是为基础动脉封闭 (BAO) 中风在24小时内建立的.
关于EVT对经过24小时治疗的BAO的安全性和有效性的数据有限.

研究的目的:

为了比较EVT的临床结果和安全性,而不是仅仅为BAO中风治疗超过24小时的医疗护理.

主要方法:

在中国进行的多中心回顾性研究 (2017年3月至2024年4月).
包括 BAO 患者在症状发作后 >24 小时内接受治疗.
使用IPTW和仪器变量分析分析了功能状态 (mRS 0-3),90天死亡率和症状性内出血.

主要成果:

90天后的良好功能状态在EVT (35.7%) 和对照组 (26.1%) 之间更高 (IPTW调整后的RR,1.67;P=.008).
在EVT和对照组之间90天死亡率没有显著差异 (48.1%对54.6%;P=10).
症状性内出血风险在EVT (11.9%) 与对照组 (1.3%) 相比显著更高 (IPTW调整后的RR,11.01;P=.02).

结论:

超过24小时的BAO中风的EVT与改善的功能结果有关.
在这个延长的窗口中使用EVT会增加症状性内出血的风险.
风险效益评估对于晚期出现BAO中风的EVT至关重要.

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