Stroke:急性缺血性中风接受机械血栓切除术的预后评估

2017-02-09 MedSci MedSci原创

少于半数的急性缺血性卒中患者接受机械血栓切除术获得永久性临床益处。因此,迫切需要了解早期再灌注的有限疗效的具体机制。近期,一项发表在杂志STROKE上的研究评估了血管壁通透性损伤的预测和预后意义及其与急性脑卒中血栓切除治疗术后血脑屏障(BCSFB)破坏的关联。此研究主要是关于支架取出器治疗急性卒中患者的前瞻性队列研究。定义血管壁通透性损伤为:在24-48小时随访对比增强磁共振成像中钆血管壁增强(G

少于半数的急性缺血性卒中患者接受机械血栓切除术获得永久性临床益处。因此,需要迫切了解早期再灌注的有限疗效的具体机制。


近期,一项发表在杂志STROKE上的研究评估了血管壁通透性损伤的预测和预后意义及其与急性脑卒中血栓切除治疗术后血脑屏障(BCSFB)破坏的关联。

此研究主要是关于支架取出器治疗急性卒中患者的前瞻性队列研究。血管壁通透性损伤定义为:在24-48小时随访对比增强磁共振成像中钆血管壁增强(GVE);严重的BCSFB破坏定义为蛛网膜下出血或脑沟钆增强(存在于> 10层面)。在随访磁共振成像中评价梗塞体积,并在第90天用改良的Rankin量表评估临床结果。

此项研究共分析了60例患者(中位数健康卒中量表评分,18),其中28例(47%)在机械性血栓切除术前静脉予以阿替普酶。总体而言,34名(57%)患者有GVE,27名(45%)患者有严重的BCSFB破坏。 GVE与血栓切除术之前使用阿替普酶显着相关,与更多的支架取回相关,以及伴随严重的BCSFB破坏。 GVE与不良的临床结果相关,GVE和严重的BCSFB破坏与最终梗死体积的增加相关。

此项研究发现可能支持直接血管损伤和急性中风后BCSFB损伤的临床相关性,并加强了进一步改善再灌注策略的需要。

原始出处:
Renú A, Laredo C, Lopez-Rueda A, et al. Vessel Wall Enhancement and Blood-Cerebrospinal Fluid Barrier Disruption After Mechanical Thrombectomy in Acute Ischemic Stroke. Stroke. 2017 Feb 7. pii: STROKEAHA.116.015648.

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175251, encodeId=5dd71e525138, content=中风还可以手术切除?, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Feb 09 23:33:52 CST 2017, time=2017-02-09, status=1, ipAttribution=)]
    2017-02-13 流恋离殇

    厉害了,中风的治疗

    0

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175251, encodeId=5dd71e525138, content=中风还可以手术切除?, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Feb 09 23:33:52 CST 2017, time=2017-02-09, status=1, ipAttribution=)]
    2017-02-09 明月清辉

    中风还可以手术切除?

    0

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