低输血强度比率预测M2中脑动脉堵塞中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风中风
Hamza Adel Salim1, Alireza Kooshki1, Dhairya A Lakhani1
1From the Neurointerventional & Neuroanalytics Consortium (NAN-C) (A.K., A.A.D.), School of Medicine, Toronto Metropolitan University, Toronto, ON, Canada; School of Medicine (A.K., A.A.D.), Birjand University of Medical Sciences, Birjand, South Khorasan, Iran; Department of Neuroradiology (H.A.S.), MD Anderson Medical Center, Houston, Texas, USA; Department of Radiology (H.A.S., D.A.L., M. H., J.M., A.C., V.S.Y.), Division of Neurology, Johns Hopkins Medical Center, Baltimore, Maryland, USA; Department of Neuroradiology (H.A.S., D.A.L.), Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA; Department of Diagnostic and Interventional Neuroradiology (A.G.), Erasme University Hospital, Brussels, Belgium; Department of Radiology (T.D.F.), Neuroendovascular Program, University Medical Center Münster, Münster, Germany; Department of Interventional Neuroradiology (J.J.H., G.W.A.), Stanford Medical Center, Palo Alto, California, USA; UCLA Stroke Center and Department of Neurology Department (D.S.L.), UCLA, Los Angeles, California, USA; Department of Radiology (D.W.), Brown University, Providence, Rhode Island, USA; Department of Radiology (A.S.), University of Cincinnati, Cincinnati, Ohio, USA and Neuroendovascular Program (A.A.D.), Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
较高的低输血强度比 (HIR) 表明附带循环较差,并且与M2闭塞的内血管血栓切除术的成功率较低有关. 这一发现有助于预测急性缺血性中风患者的治疗结果.
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:
- 内血管血栓切除术 (EVT) 对来自M2中脑动脉 (MCA) 阻塞的急性缺血性中风的有效性仍在争论中.
- 与大血管封闭相比,M2封闭中的更低的再通道率有助于不确定性.
- 低 perfusion 强度比 (HIR) 反映了附带血流,但其与 M2 阻塞中 EVT 成功的关系尚不清楚.
研究的目的:
- 调查M2 MCA闭塞患者中HIR和EVT技术成功之间的关系.
- 为了确定HIR是否可以预测成功的再通道化 (mTICI 2b-3) 在这个患者群体.
- 探索输液成像在评估M2阻塞中风管理的附带状态的实用性.
主要方法:
- 对一家跨国注册机构 (MAD-MT联盟) 对为M2 MCA封闭而接受EVT的患者进行了回顾性分析.
- 纳入标准:2017年9月至2023年7月期间M2 MCA封闭的EVT.
- 多变量后勤回归用于评估HIR与成功EVT的关联 (mTICI 2b-3),控制其他因素.
主要成果:
- 在111名患者中,79%的人取得了成功的EVT (mTICI 2b-3).
- 在成功进行EVT的患者中观察到较低的HIR值 (0.20对0.50,p=0.007).
- 较高的HIR独立地与较低的成功EVT几率相关 (OR0.03,p=0.009),表明抵押品流通受损.
结论:
- 低 perfusion 强度比 (HIR) 可以预测M2 MCA封闭中成功的内血管血栓切除术.
- 在管理M2闭塞中风时,HIR可以作为临床决策的宝贵工具.
- 基于输液成像的附带评估对于这些中风患者的预后至关重要.
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