Acute ischemic stroke is one of the common discases in Chinese,among which acute ischemic stroke with large vessel occlusion(AIS-LVO)has thc most serious complications and has the risk of death.Studies have shown that...Acute ischemic stroke is one of the common discases in Chinese,among which acute ischemic stroke with large vessel occlusion(AIS-LVO)has thc most serious complications and has the risk of death.Studies have shown that reperfusion is a first-line treatment for the effective rescue of ischemic brain tissue,usually mainly by mechanical|hrombectomy(MT),supplemented by intravenous thrombolysis.However,there are still complications after large blood vessel occlusion and MT.such as blecding and infection at the puncture point,vasospasm,vascular dissection,subarachnoid hemorrhage,hcmonhagic transfomation,reembolization,and massive cerebral infarction,ctc.The high risk factors and corresponding measures of complications after MT by revicwing the rescarch analysis.展开更多
Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospecti...Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospectively collected from 66 patients with acute ischemic stroke admitted to the Department of Neurology of Tongliao Hospital and Xuanwu Hospital from August 2019 to November 2021 within 4.5 hours.According to the different recanalization methods,30 patients were assigned to the direct thrombectomy treatment group,and 36 patients in the bridging treatment group(i.e.,the intravenous thrombolysis bridging mechanical thrombectomy treatment group).The primary outcome measure was the neurological outcome at the onset of 90d.Secondary outcome measures were intraoperative vascular recanalization and reperfusion,and the US National Institute of Health Stroke Scale score at 24 hours after surgery.The primary safety indicators are intracranial hemorrhage,including symptomatic intracranial hemorrhage and non-symptomatic intracranial hemorrhage,and 90d mortality.Results:The direct thrombectomy group had lower body mass index,hypertension and baseline Alberta early computed tomography score than the bridging treatment group,and longer time from onset to visit than the bridging group(206.5(119.5,256.25)min vs.150.5(25.205,212.75)min),the above difference were statistically significant(P<0.05).There were no significant differences in successful vascular reperfusion(93%vs.89%),24 hours postoperative National Institute of Health Stroke Scale score(11(5,18)vs.11(5,20)),intracranial hemorrhage(11%vs.14%),symptomatic intracranial hemorrhage(7%vs.17%),90d mRS0 to 2 points(43%vs.36%)and 90d mortality(23%vs.22%)(P>0.05).Conclusion:Similar clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke within 4.5 hours of onset,direct thrombectomy can be used as an alternative scheme for acute anterior circulation intracranial large artery occlusive stroke.展开更多
目的探讨凝视-面-臂-言语-时间(gaze-face-arm-speech-time,G-FAST)评分对院前急救卒中前循环大血管闭塞(large vessel occlusion in the anterior circulation,aLVO)的诊断价值。方法选取2019年7月至2020年12月北京急救中心直属5个分...目的探讨凝视-面-臂-言语-时间(gaze-face-arm-speech-time,G-FAST)评分对院前急救卒中前循环大血管闭塞(large vessel occlusion in the anterior circulation,aLVO)的诊断价值。方法选取2019年7月至2020年12月北京急救中心直属5个分中心送至宣武医院,且有完整院前G-FAST评分和入院诊断信息的卒中患者,根据缺血性卒中患者是否发生LVO分为LVO和非LVO组,采用ROC曲线分析G-FAST评分对院前卒中急救aLVO的诊断价值。结果纳入患者352例,其中急性缺血性卒中占比69.0%(243/352)。进行大血管评估的急性缺血性卒中患者149例,占急性缺血性卒中的61.3%(149/243);发生aLVO患者61例,占大血管病变评估的40.9%(61/149)、占急性缺血性卒中的25.1%(61/243)。149例大血管评估的急性缺血性卒中患者中,男100例,女49例;年龄18~93岁,平均70.5岁。与非aLVO组相比,aLVO组女性较多,G-FAST评分较高,差异均有统计学意义(P<0.05)。G-FAST≥3分患者的aLVO发生率显著高于G-FAST≤2分者(68.9%比31.1%),差异有统计学意义(P<0.05)。G-FAST评分诊断院前急救卒中aLVO的ROC曲线的AUC为0.675(95%CI:0.589~0.761,P=0.000),G-FAST的cut-off值为2.5分时,灵敏度为72.10%,特异度为58.00%。结论G-FAST评分在院前急救卒中可准确识别急性缺血性患者aLVO,早诊断aLVO将利于急性缺血性患者尽早送至高级别卒中中心。展开更多
基金High Level Talent Program of Hainan Natural Science Foundation(No.821RC680)。
文摘Acute ischemic stroke is one of the common discases in Chinese,among which acute ischemic stroke with large vessel occlusion(AIS-LVO)has thc most serious complications and has the risk of death.Studies have shown that reperfusion is a first-line treatment for the effective rescue of ischemic brain tissue,usually mainly by mechanical|hrombectomy(MT),supplemented by intravenous thrombolysis.However,there are still complications after large blood vessel occlusion and MT.such as blecding and infection at the puncture point,vasospasm,vascular dissection,subarachnoid hemorrhage,hcmonhagic transfomation,reembolization,and massive cerebral infarction,ctc.The high risk factors and corresponding measures of complications after MT by revicwing the rescarch analysis.
基金supported by Health Science and Technology Project of Inner Mongolia Autonomous Region 2022(202201571).
文摘Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospectively collected from 66 patients with acute ischemic stroke admitted to the Department of Neurology of Tongliao Hospital and Xuanwu Hospital from August 2019 to November 2021 within 4.5 hours.According to the different recanalization methods,30 patients were assigned to the direct thrombectomy treatment group,and 36 patients in the bridging treatment group(i.e.,the intravenous thrombolysis bridging mechanical thrombectomy treatment group).The primary outcome measure was the neurological outcome at the onset of 90d.Secondary outcome measures were intraoperative vascular recanalization and reperfusion,and the US National Institute of Health Stroke Scale score at 24 hours after surgery.The primary safety indicators are intracranial hemorrhage,including symptomatic intracranial hemorrhage and non-symptomatic intracranial hemorrhage,and 90d mortality.Results:The direct thrombectomy group had lower body mass index,hypertension and baseline Alberta early computed tomography score than the bridging treatment group,and longer time from onset to visit than the bridging group(206.5(119.5,256.25)min vs.150.5(25.205,212.75)min),the above difference were statistically significant(P<0.05).There were no significant differences in successful vascular reperfusion(93%vs.89%),24 hours postoperative National Institute of Health Stroke Scale score(11(5,18)vs.11(5,20)),intracranial hemorrhage(11%vs.14%),symptomatic intracranial hemorrhage(7%vs.17%),90d mRS0 to 2 points(43%vs.36%)and 90d mortality(23%vs.22%)(P>0.05).Conclusion:Similar clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke within 4.5 hours of onset,direct thrombectomy can be used as an alternative scheme for acute anterior circulation intracranial large artery occlusive stroke.
文摘目的探讨凝视-面-臂-言语-时间(gaze-face-arm-speech-time,G-FAST)评分对院前急救卒中前循环大血管闭塞(large vessel occlusion in the anterior circulation,aLVO)的诊断价值。方法选取2019年7月至2020年12月北京急救中心直属5个分中心送至宣武医院,且有完整院前G-FAST评分和入院诊断信息的卒中患者,根据缺血性卒中患者是否发生LVO分为LVO和非LVO组,采用ROC曲线分析G-FAST评分对院前卒中急救aLVO的诊断价值。结果纳入患者352例,其中急性缺血性卒中占比69.0%(243/352)。进行大血管评估的急性缺血性卒中患者149例,占急性缺血性卒中的61.3%(149/243);发生aLVO患者61例,占大血管病变评估的40.9%(61/149)、占急性缺血性卒中的25.1%(61/243)。149例大血管评估的急性缺血性卒中患者中,男100例,女49例;年龄18~93岁,平均70.5岁。与非aLVO组相比,aLVO组女性较多,G-FAST评分较高,差异均有统计学意义(P<0.05)。G-FAST≥3分患者的aLVO发生率显著高于G-FAST≤2分者(68.9%比31.1%),差异有统计学意义(P<0.05)。G-FAST评分诊断院前急救卒中aLVO的ROC曲线的AUC为0.675(95%CI:0.589~0.761,P=0.000),G-FAST的cut-off值为2.5分时,灵敏度为72.10%,特异度为58.00%。结论G-FAST评分在院前急救卒中可准确识别急性缺血性患者aLVO,早诊断aLVO将利于急性缺血性患者尽早送至高级别卒中中心。
