机械取栓治疗急性缺血性脑卒中的预后和并发症。

Cardiology and cardiovascular medicine Pub Date : 2024-01-01 Epub Date: 2024-12-10
Zubair Ahmed, Jeremy Pan, Tony Eskandar, Devendra K Agrawal
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引用次数: 0

摘要

一般来说,中风表现为由于大脑特定区域的血液供应受阻而导致的神经功能障碍。在中风的三大类中,急性缺血性中风是全世界死亡和残疾的主要原因。目前,有两种有效的治疗方法:溶栓和血管内治疗。通过组织纤溶酶原激活剂进行静脉溶栓治疗通常在症状出现后4.5小时内进行。机械取栓是血管内治疗的一种,适用于自患者最后一次无症状后24小时内发生大血管闭塞的急性缺血性卒中。由于静脉溶栓治疗存在时间窗有限、禁忌症多等缺点,研究证明机械取栓作为治疗前循环大血管闭塞急性缺血性卒中的标准治疗方法是有效的。与静脉溶栓治疗相比,血管内治疗具有更高的独立临床转归率和再灌注成功率。目前,支架回收器和抽吸装置是两种最常见的血管内治疗技术。两项著名的研究比较了这两种技术之间的再灌注率,但没有发现哪一种技术比另一种更有益。使用支架回收器还是直接抽吸取决于患者和所涉及的血栓。这篇综合性文章批判性地讨论了机械取栓治疗急性缺血性卒中的疗效及其相关结果和并发症的研究结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes and Complications Associated with Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke.

Universally, stroke presents as neurological deficits due to the obstruction of blood supply to specific regions of the brain. Among the three main categories of stroke, acute ischemic stroke is the leading cause of death and disability worldwide. As of today, there are two effective treatment methods: thrombolysis and endovascular therapy. Intravenous thrombolysis treatment via tissue plasminogen activator is typically administered within 4.5 hours from the onset of symptoms. Mechanical thrombectomy, a type of endovascular therapy, is indicated for acute ischemic stroke due to a large vessel occlusion occurring within 24 hours since the patient was last seen asymptomatic. Due to the disadvantages of intravenous thrombolysis treatment, such as a limited time window and numerous contraindications, studies have proven the efficacy of mechanical thrombectomy as the standard of care for acute ischemic stroke due to large vessel occlusion in the anterior circulation. Endovascular therapy was associated with higher rates of independent clinical outcome and successful reperfusion rates compared to intravenous thrombolysis treatment. Currently, stent retrievers and aspiration devices are the two most common endovascular therapy techniques. Two prominent studies compared the reperfusion rates between these two techniques, but neither was found to be more beneficial than the other. The decision to use either a stent retriever or direct aspiration depends on the patient and the thrombus involved. This comprehensive article critically discusses the findings on the efficacy of mechanical thrombectomy therapy for acute ischemic stroke and its associated outcomes and complications.

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