Stroke:机械性血栓切除术对治疗轻中度脑卒中患者益处!

2017-11-05 MedSci MedSci原创

近端大血管闭塞(LVO)约占轻微中风患者比例的30%。目前,关于机械性血栓切除术(MT)在前循环LVO轻微卒中亚组中的治疗有效性仍有争议。关于这一亚组患者的MT研究数据很少,而且关于他们的最佳管理尚未确定。基于此,近期,一项发表在杂志Stroke上的多中心队列研究旨在评估由于前循环中LVO的急性缺血性中风(AIS)患者使用MT的有效性,研究对象为呈现轻度至中度中风症状(National Insti

近端大血管闭塞(LVO)约占轻微中风患者比例的30%。目前,关于机械性血栓切除术(MT)在前循环LVO轻微卒中亚组中的治疗有效性仍有争议。关于这一亚组患者的MT研究数据很少,而且关于他们的最佳管理尚未确定。


基于此,近期,一项发表在杂志Stroke上的多中心队列研究旨在评估由于前循环中LVO的急性缺血性中风(AIS)患者使用MT的有效性,研究对象为呈现轻度至中度中风症状(National Institutes of Health Stroke Scale score < 8)。

此项多中心队列研究涉及4个综合卒中中心,对研究对象进行2种治疗方法(紧急血栓切除术与最佳药物治疗[BMT] vs. 首先予以BMT,如果病情恶化予以MT)。随后进行意向治疗分析。此项研究的主要终点是在3个月时,改良Rankin量表评分达到0到1的优异结果率。

最终,共纳入310例患者,其中170例患者进行急诊MT联合BMT,131例患者一线予以BMT单药治疗。

接受MT治疗的患者年龄更小,更常接受静脉溶栓治疗,成像时间更短。药物治疗组中有24例患者(18.0%)由于神经功能恶化而进行MT抢救。

总体而言,64.5%的患者获得了良好的结果,两组间无显著差异。根据关键亚组的分层分析没有发现治疗效应大小的异质性。

此项研究结果表明:轻度至中度LVO卒中患者在3个月内无论接受紧急MT,还是BMT后进行的MT均可以获得相似的有利的功能结果。

原始出处:
Dargazanli C, Arquizan C, et al. Mechanical Thrombectomy for Minor and Mild Stroke Patients Harboring Large Vessel Occlusion in the Anterior Circulation: A Multicenter Cohort Study. Stroke. 2017 Oct 31. pii: STROKEAHA.117.018113. doi: 10.1161/STROKEAHA.117.018113.

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    2017-11-05 有备才能无患

    近端大血管闭塞(LVO)约占轻微中风患者比例的30%.目前.关于机械性血栓切除术(MT)在前循环LVO轻微卒中亚组中的治疗有效性仍有争议.关于这一亚组患者的MT研究数据很少.而且关于他们的最佳管理尚未确定.

    0

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