对于最近出现症状的动脉狭窄症,DSA与重新血管化的非侵入性成像转诊
Jane Khalife1,2, Hamail Iqbal2, Manisha Koneru1
1Cooper Neurological Institute Cooper University Health Care Camden NJ.
Stroke (Hoboken, N.J.)
|January 29, 2026
概括
根据非侵入性成像,将近23%的患者被转诊进行动脉再血管化,在数字减去血管学 (DSA) 上缺乏狭窄. 这种差异影响了症状性动脉狭窄症的重血管化决定.
科学领域:
- 血管外科 血管外科
- 神经学 神经学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 目前的动脉狭窄复血管化指南依赖于数字减去血管学 (DSA) 发现.
- 临床实践经常使用非侵入性成像来做出重新血管化的决定.
- 在评估狭窄症严重程度时,非侵入性成像和DSA之间的差异令人担忧.
研究的目的:
- 评估非侵入性成像和DSA之间的动脉狭窄严重程度评估中的差异.
- 确定这些差异对重新血管化的决定的影响.
主要方法:
- 在2019-2024年期间,对463名接受DSA治疗的患者进行了回顾性分析,以治疗症状性心血管狭窄.
- 纳入标准:急性缺血事件,在非侵入性成像上中度至重度狭窄.
- 主要结局:非侵入性成像和DSA之间病变严重程度的分歧率.
主要成果:
- 在22.7%的患者中观察到狭窄症严重程度的分歧.
- 不一致群体之间立即重血管化率的显著差异 (P<0.001).
- 在63%的不一致病例中,发现了其他中风病因,需要进一步的诊断.
结论:
- 与非侵入性成像相比,几乎四分之一的被转诊进行动脉再血管化治疗的患者在DSA上表现出不够的狭窄.
- 这突显出一个显著的不一致性影响临床决策对于动脉再血管化.
- 研究结果表明,需要重新评估当前的转诊和诊断途径.
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