皮卡索 (近端内 Carotid 动脉急性中风二次并列损伤或局部阻塞) 血栓切除随机试验:研究协议和理由
Sami Al Kasab1, Thanh N Nguyen2, Mohamad Abdalkader2
1Department of Neurology and Neurosurgery Medical University of South Carolina Charleston SC.
Stroke (Hoboken, N.J.)
|January 23, 2026
概括
皮卡索试验调查了急性动脉支架与急性缺血性中风与大血管封闭的没有支架. 结果将指导这些复杂的中风病例的最佳治疗.
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:
- 对于急性大血管封闭 (LVO) 与并发的内动脉 (ICA) 狭窄封闭性疾病的最佳治疗方法尚未确定.
- 双重病变,包括内和外闭塞,在急性缺血性中风管理中提出了独特的治疗挑战.
研究的目的:
- 为了确定急性带支架是否优于非急性支架的方法,在急性缺血性中风和双重闭塞的患者中.
- 评估机械血栓切除术与新兴动脉支架相结合的安全性和疗效,与单独的机械血栓切除术相比.
主要方法:
- 一个前性的,随机的,受控的,多中心的,开放的标签,评估者盲目的试验 (PICASSO) 招募了多达404名患者.
- 患有前部循环LVO和严重的额外头ICA狭窄或闭塞的患者随机分别1:1进行机械血栓切除术与新兴支架或机械血栓切除术没有支架.
- 治疗时间从最后一个已知的井时间开始至16小时,根据临床和成像合格标准进行随机选择.
主要成果:
- 主要疗效终点是90天修改的兰金尺度 (mRS) 评分的顺序转移.
- 主要安全结局是症状性内出血.
- 二级结局包括1年的mRS,再注射率和血管通透性,计划对抗血小板策略和治疗顺序进行子组分析.
结论:
- 皮卡索试验是一项实用性随机研究,旨在解决急性动脉支架与机械血栓切除相结合的安全性和有效性,用于同时出现额外缩或闭塞的前部循环LVO.
- 这些发现将为管理涉及双重病变的复杂中风表现提供临床决策的信息.
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