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在急性缺血性中风的内救援支架后的结果.

Christine Tschoe1, Stephanie Coffman2, Carol Kittel2

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概括

在机械血栓切除术 (MT) 失败后的救援支架 (RS) 显著改善了新出现的大血管封闭患者的结果. 这种方法提供了比保守治疗更好的结果,而不会大幅增加符合条件的患者的出血风险.

关键词:
急性缺血性中风是急性缺血性中风.新出现的大血管封闭.血管内治疗疗法 血管内疗法内支架是用于内支架.机械血栓切除术是一种机械血栓切除术.抢救救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援救援血栓切除术失败是因为失败.

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科学领域:

  • 神经学 神经学
  • 干预性神经放射学 干预性神经放射学
  • 血管外科 血管外科

背景情况:

  • 机械血栓切除术 (MT) 是急性缺血性中风的标准治疗方法.
  • 在MT之后未能进行重新道化,需要采用替代策略.
  • 在失败的MT后,救援支架 (RS) 的有效性尚未得到充分证实.

研究的目的:

  • 评估在机械血栓切除术 (MT) 失败后出现大血管封闭的患者的内救援支架 (RS) 的结果.
  • 为了比较RS结果与持续的大血管封闭的自然史.
  • 评估与RS相关的并发症.

主要方法:

  • 在MT (2014-2019) 失败后接受RS的患者的回顾性分析.
  • 根据包含/排除标准,与主要MT试验 (MR CLEAN,ESCAPE,DAWN) 的历史对照组进行比较.
  • 对再输血率和90天功能结果的评估 (修改的兰金度表).

主要成果:

  • 在85.8%的病例中,RS实现了再输血 (脑梗塞中血栓溶解≥2B).
  • 在33.9%的RS患者中,观察到90天的良好结果 (mRS 0-2).
  • 与MR CLEAN (40.8%对19%) 和DAWN (27%对13%) 医疗手臂相比,RS患者满足试验标准的结果明显更好.
  • 与MR CLEAN相比,症状性内出血没有显著增加,但与DAWN相比增加了.

结论:

  • 在机械血栓切除术 (MT) 失败后的救援支架 (RS) 显著改善了符合条件的患者的治疗结果.
  • 在失败的MT之后,RS为保守管理提供了优质的替代方案.
  • 在早期血栓切除窗口中,出血并发症并没有显著增加,结果与成功的MT相似.