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血管内血栓切除术患者的抗凝疗 血管内血栓切除术患者因心血管栓塞引起的大血管封闭
Jae Beom Hong1,2, William K Diprose1,2, Michael T M Wang1
1Department of Medicine Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand.
Stroke (Hoboken, N.J.)
|January 26, 2026
概括
许多心血管栓塞性中风患者缺乏足够的抗凝剂,增加了内血管血栓切除术 (EVT) 的需要. 优化口服抗凝剂 (OAC) 治疗可能会防止许多EVT手术.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 血管医学 血管医学
背景情况:
- 心血管栓塞,通常来自心房动 (AF),是导致大血管封闭 (LVO) 的缺血性中风的主要原因.
- 不充分的口服抗凝剂 (OAC) 治疗仍然是患有AF,机械心脏门和其他栓塞来源的患者面临的重大挑战.
- 内血管血栓切除术 (EVT) 是LVO的关键治疗方法,但了解中风前OAC的充足性至关重要.
研究的目的:
- 在接受EVT的患者中评估心血管血管LVO的发生率.
- 评估OAC治疗在患有心血管血栓性LVO和前中风抗凝药的指示患者的充分性.
- 确定适当的OAC治疗与EVT后的临床结果之间的关联.
主要方法:
- 对连续使用EVT治疗心血管血栓性LVO的患者进行了回顾性分析.
- 评估中风前的OAC指示和抗凝剂的适当性.
- 评估主要结果 (3个月功能独立) 和次要结果 (神经恢复,出血,死亡率).
主要成果:
- 超过一半 (53.1%) 的EVT治疗患者患有心血管血栓性LVO,心房动是最常见的原因.
- 只有27.7%的患有中风前OAC的患者在LVO时得到了足够的抗凝剂.
- 充足的抗凝剂与整体EVT结果无关,但与较低的内动脉封闭率和患有AF患者更高的功能独立性有关.
结论:
- 由于LVO而接受EVT的患者中有很大一部分患有心血管栓塞原因.
- 低抗凝率在患有心血管血栓性LVO的患者中普遍存在,这些患者对OACs有迹象.
- 改善OAC管理可能会减少大量患者对EVT程序的需求.
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