评价重组组织型纤溶酶原激活剂预处理对直接桥接治疗的大动脉闭塞急性脑卒中患者的效果。这样做是否值得？
Evaluation of the recombinant tissue plasminogen activator pretreatment in acute stroke patients with large vessel occlusions treated with the direct bridging approach. Is it worth the effort?
机构信息
Department of Radiology, Stavanger University Hospital, Stavanger, Norway; Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.
出版信息
Eur J Neurol. 2015 Feb;22(2):322-7. doi: 10.1111/ene.12569. Epub 2014 Sep 25.
BACKGROUND AND PURPOSE
The direct bridging concept in acute stroke treatment combines intravenous thrombolysis (IVT) and endovascular treatment (EVT). The frequency and extent of reperfusion obtained already due to IVT were evaluated. Additionally undesired events and the clinical outcome were analysed.
METHODS
Fifty-seven acute stroke patients treated with direct bridging were analysed for this study. The response to IVT was evaluated according to the modified Thrombolysis in Cerebral Infarction scale (m-TICI). IVT responders (m-TICI ≥2B in digital subtraction angiography) were compared with IVT non-responders (m-TICI <2B in digital subtraction angiography) with respect to clinical outcome and occurrence of undesired events.
RESULTS
Fourteen patients (25%) got a change from TICI 0 to ≥2B due to IVT alone. There were otherwise no differences between the IVT responders and IVT non-responders.
CONCLUSIONS
Intravenous thrombolysis pretreatment in the context of the bridging approach contributes substantially to revascularization.
背景与目的
急性脑卒中治疗中的直接桥接概念将静脉溶栓（IVT）和血管内治疗（EVT）结合在一起。本研究评估了由于 IVT 已经获得的再灌注的频率和程度。此外，还分析了不良事件和临床结果。
方法
本研究分析了 57 例采用直接桥接治疗的急性脑卒中患者。根据改良脑梗死溶栓分级（m-TICI）评估 IVT 反应。将 IVT 应答者（数字减影血管造影术 m-TICI ≥2B）与 IVT 无应答者（数字减影血管造影术 m-TICI＜2B）进行比较，观察临床结果和不良事件的发生情况。
结果
14 例患者（25%）由于单独 IVT，从 TICI 0 变为≥2B。IVT 应答者和 IVT 无应答者之间没有其他差异。
结论
在桥接治疗方法中，静脉溶栓预处理对再灌注有重要贡献。
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