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Circulation子刊:颈动脉支架置入术在临床中长期疗效的分析

2016-10-05 xing.T MedSci原创

研究结果表明在有经验的医疗中心进行颈动脉支架置入术用于卒中的长期预防是有效的,尽管那些被对照临床试验排除的患者也进行颈动脉支架置入术。然而,这些患者仍然存在着巨大的急性主要不良心脏或脑血管事件的风险。

颈动脉支架置入可以降低卒中风险,但是缺乏长期的和颈动脉支架置入术对照临床试验之外的数据,近日,心血管领域权威杂志《Circulation: Cardiovascular Interventions》上发表了一篇研究文章,试图评估颈动脉支架置入在卒中预防方面的长期有效性。

该项目是一项严格控制纳入标准的前瞻性研究,有明确的随访流程,以及独立的术前和术后神经功能评估。在1999年11月至2015年3月期间,在一个单一的医疗中心连续共有901例患者进行了1000次支架置入,患者平均年龄为71±9岁,症状性狭窄患者为262例(29.1%),这些研究对象具有很高的并发症患病率。根据CREST研究(颈动脉内膜剥脱术与顶支架试验)协议,289例患者(32.1%)被排除,中位随访时间为5.5(四分位距为2.6–7.9)年,93%的患者完成随访流程。研究的主要终点事件(复合的卒中、死亡和心肌梗死[主要不良心脏或脑血管事件])发生率为6.9%(9.9%的终点事件发生在有症状患者,5.7%发生于无症状患者,P=0.03)。相比于没被排除的患者,在被CREST研究排除的289例患者中研究主要终点事件发生率较高(11.4% vs 4.9%;P=0.001)。

研究结果表明,在有经验的医疗中心进行颈动脉支架置入术用于卒中的长期预防是有效的。那些被临床对照试验排除的患者有很大一部分也行颈动脉支架置入术。然而,这些患者仍然存在很大的急性心脑血管事件的风险。

原始出处:

Harald Mudra, et al. Long-Term Outcomes of Carotid Artery Stenting in Clinical Practice. Circulation: Cardiovascular Interventions. 2016;9:e004950.

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1984468, encodeId=441b198446854, content=<a href='/topic/show?id=5f7310054216' target=_blank style='color:#2F92EE;'>#颈动脉支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100542, encryptionId=5f7310054216, topicName=颈动脉支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Wed Jun 21 16:04:00 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026441, encodeId=ccc6202644152, content=<a href='/topic/show?id=31e11005481a' target=_blank style='color:#2F92EE;'>#颈动脉支架置入术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100548, encryptionId=31e11005481a, topicName=颈动脉支架置入术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Dec 25 05:04:00 CST 2016, time=2016-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766688, encodeId=bbd41e6668807, content=<a href='/topic/show?id=fc89e965910' target=_blank style='color:#2F92EE;'>#置入术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79659, encryptionId=fc89e965910, topicName=置入术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bd637855499, createdName=小小小向日葵, createdTime=Sun Nov 20 07:04:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843425, encodeId=4ff618434257f, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Sat Mar 18 11:04:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146120, encodeId=63c9146120c3, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 22:40:45 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146118, encodeId=7d4d1461189c, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 22:40:39 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145488, encodeId=35821454883f, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 20:25:12 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553463, encodeId=c1c71553463c1, content=<a href='/topic/show?id=3b409e02804' target=_blank style='color:#2F92EE;'>#长期疗效#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97028, encryptionId=3b409e02804, topicName=长期疗效)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fe2a14383573, createdName=gjsgj, createdTime=Fri Oct 07 07:04:00 CST 2016, time=2016-10-07, status=1, ipAttribution=)]
    2016-10-11 知难而进

    继续关注!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1984468, encodeId=441b198446854, content=<a href='/topic/show?id=5f7310054216' target=_blank style='color:#2F92EE;'>#颈动脉支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100542, encryptionId=5f7310054216, topicName=颈动脉支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Wed Jun 21 16:04:00 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026441, encodeId=ccc6202644152, content=<a href='/topic/show?id=31e11005481a' target=_blank style='color:#2F92EE;'>#颈动脉支架置入术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100548, encryptionId=31e11005481a, topicName=颈动脉支架置入术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sun Dec 25 05:04:00 CST 2016, time=2016-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766688, encodeId=bbd41e6668807, content=<a href='/topic/show?id=fc89e965910' target=_blank style='color:#2F92EE;'>#置入术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79659, encryptionId=fc89e965910, topicName=置入术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bd637855499, createdName=小小小向日葵, createdTime=Sun Nov 20 07:04:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843425, encodeId=4ff618434257f, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Sat Mar 18 11:04:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146120, encodeId=63c9146120c3, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 22:40:45 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146118, encodeId=7d4d1461189c, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Tue Oct 11 22:40:39 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145488, encodeId=35821454883f, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 20:25:12 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553463, encodeId=c1c71553463c1, content=<a href='/topic/show?id=3b409e02804' target=_blank style='color:#2F92EE;'>#长期疗效#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97028, encryptionId=3b409e02804, topicName=长期疗效)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fe2a14383573, createdName=gjsgj, createdTime=Fri Oct 07 07:04:00 CST 2016, time=2016-10-07, status=1, ipAttribution=)]
    2016-10-11 知难而进

    谢谢分享!

    0

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    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

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