JACC:与无保护手术相比,经导管主动脉瓣置换中的脑血栓保护显著降低死亡和卒中

2017-11-21 xiangting MedSci原创

与无保护TAVR相比,在接受TAVR的患者中使用脑栓塞保护装置使得无卒中生存率更高。

血栓保护装置的影像学数据显示脑损伤的数量和体积显著减少。这项研究的目的是评估经导管主动脉瓣置换术(TAVR)的患者脑血栓保护对无卒中生存率的影响。

入选802例连续性患者。34.9%(n = 280)的连续患者使用Sentinel脑栓塞保护装置(Claret Medical Inc.,Santa Rosa,加州)。除了没有脑血栓保护外,65.1%(n = 522)患者在相同情况下进行了TAVR。术后7天内进行神经学随访。主要终点是7天内根据Valve Academic Research Consortium-2标准的全因死亡率或全卒中的复合。使用倾向得分匹配以说明可能的混杂因素。

305例连续患者中有280例(91.8%)成功放置了该装置的两个过滤器。在倾向匹配人群(n = 560)中,使用脑栓塞保护装置将残疾率和非残疾卒中率从4.6%降到1.4%(p = 0.03;比值比:0.29,95%可信区间:0.10-0.93)。主要终点的发生率显著降低,保护组为2.1%(n = 6),而对照组为6.8%(n = 19)(p = 0.01;比值比为0.30,95%置信区间:0.12-0.77)。在多变量分析中,胸外科协会的死亡率评分(p = 0.02)和无保护TAVR(p = 0.02)是主要终点的独立预测因子。

与无保护TAVR相比,在接受TAVR的患者中使用脑栓塞保护装置使得无卒中生存率更高。

原始出处:

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    2018-08-27 hbwxf
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    2018-05-15 yxch48
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  5. 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time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263348, encodeId=679a263348e5, content=好好学习天天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 22 12:58:59 CST 2017, time=2017-11-22, status=1, ipAttribution=)]
  8. 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time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263348, encodeId=679a263348e5, content=好好学习天天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 22 12:58:59 CST 2017, time=2017-11-22, status=1, ipAttribution=)]
    2017-11-23 lsj631
  9. 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time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263348, encodeId=679a263348e5, content=好好学习天天学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 22 12:58:59 CST 2017, time=2017-11-22, status=1, ipAttribution=)]
    2017-11-22 虈亣靌

    好好学习天天学习

    0