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喉自由浮动血栓的管理:一个系统的审查

Oumaima Aouam¹, Carolijn J M de Bresser¹, Eline S van Hattum¹

¹Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.

Journal of vascular surgery

|March 5, 2026

概括

在动脉中自由浮动的血栓 (cFFT) 具有较高的中风风险,治疗数据有限. 目前的策略显示了相当大的中风或死亡风险,这表明单独的抗凝药可能不足.

科学领域:

血管外科血管外科
神经学神经学
心血管医学心血管医学

背景情况:

喉动脉中的自由浮动血栓 (cFFT) 是中风的重要危险因素.
缺少cFFT的现有治疗指南,需要审查当前的管理策略.
对cFFT的干预措施的安全性和有效性需要彻底调查,因为相关风险很高.

研究的目的:

系统地审查和确定现有管理策略,以免费浮动的动脉血栓 (cFFT).
根据现有的文献,评估各种治疗cFFT的安全性和有效性.
为未来的研究和cFFT标准化治疗方案提供见解.

主要方法:

系统地搜索PubMed和Embase数据库的文献,直到2025年5月.
包括报告cFFT患者治疗和临床结果的研究.
使用非随机化研究 (MINORS) 方法指数得分的数据提取和质量评估;主要终点是短期 (<30天) 和长期 (>30天) 随访的复合死亡/中风率.

主要成果:

分析了11项低质量的研究,涉及179名cFFT患者;没有确定随机对照试验.
确定了20种治疗策略,包括抗血栓药物 (AM),内血管治疗 (EVT) 和大脑动脉内关节切除术 (CEA).
短期死亡/中风率仅在AM中最高 (6.7%),其次是EVT (5.0%) 和CEA (2.6%). 长期数据仅用于AM (6.5%的死亡/中风率).

结论:

对cFFT管理的高质量证据有限,所有审查的策略都带有重大中风或死亡风险.
单靠抗凝药似乎是不够的,可能会挑战当前的指导方针,而CEA可能是一个更有利的外科选择.
由于样本规模较小,研究结果应谨慎解释,但可能会为未来的研究设计和对cFFT的治疗标准化提供信息.

关键词:

血管内脏的内血管.自由漂浮的血栓可以自由漂浮.管理管理管理管理医学疗法医学疗法医学疗法外科手术手术手术系统审查是系统的审查.

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