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Stroke:对于急性基底动脉闭塞,潜在性狭窄对机械取栓术有何影响?

2020-03-31 shaosai MedSci原创

近期研究表明,对急性基底动脉(BAO)闭塞行机械性取栓术能够获得成功的再通及良好的预后,但对于结果的预测指标尚不明确。不同的闭塞类型行机械取栓术患者获益不同,这表明基底动脉狭窄(BS)对其具

背景和目的

近期研究表明,对急性基底动脉(BAO)闭塞行机械性取栓术能够获得成功的再通及良好的预后,但对于结果的预测指标尚不明确。不同的闭塞类型行机械取栓术患者获益不同,这表明基底动脉狭窄(BS)对其具有影响。本研究旨在评估BAO不同亚型的影像学和临床特征差异,识别不同闭塞亚型相关的征象。

方法

本研究纳入了有BAO且行机械行取栓术的患者。对不同的闭塞类型,尤其是提示BS的临床(NIHSS、mRS)和影像学指标进行分析(n=115)。利用CT检查对不同临床亚型的血栓进行测量血栓密度。

结果

尽管两组血管再通率相差无几(合并BS的BAO和非合并BS的BAO组分别为87%、95%),BS组预后相关临床指标(NIHSS、mRS)要显著差于非BS组(P=0.002/0.003)。BS组在平扫时血栓密度要明显低于非BS组,渗透相关指标Δt (平均为 34.6 Hounsfield units) 、ε (平均为0.23)要高于非BS组(mean, 53.6 Hounsfield units/13.1 Hounsfield units/0.08, P=0.01/ 0.004/ 0.001)。

结论

本研究表明,与前期研究一致,BAO机械取栓术的成功再通与狭窄病因具有相关性,具有BS的患者获益相对较小。血栓渗透性对鉴别急性BAO有无BS具有潜在价值,可能作为入院评价BS的影像学指标。

原始出处:

Berndt MT 1, Pree D 1, Kaesmacher J. et al. From Perviousness to Plaque Imaging in Acute Basilar Occlusions: The Impact of Underlying Stenosis and How to Detect It. DOI: 10.1161/STROKEAHA.119.027472

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    2020-04-01 wxl882001

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