直接口服抗凝剂在颈动脉夹层和脑静脉血栓形成患者中的应用：病例系列和文献复习。
Direct oral anticoagulants in patients with cervical artery dissection and cerebral venous thrombosis. A case series and review of the literature.
机构信息
USD Stroke Unit, DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
USD Stroke Unit, DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
出版信息
Int J Cardiol. 2017 Oct 1;244:282-284. doi: 10.1016/j.ijcard.2017.06.006. Epub 2017 Jun 13.
BACKGROUND
To date, very little is known about the effects of direct oral anticoagulants (DOA) use in patients with cervical artery dissection (CAD) and cerebral venous thrombosis (CVT). We present our initial experience with the use of DOA for CAD and CVT and an overview of the published literature.
METHODS
From our database, we identified 4 patients who received DOA after CAD and 4 patients after CVT. Also, we analyzed the data reported for 45 patients who received DOA after CAD and 23 after CVT from review of the literature.
RESULTS
Among patients with CAD, resolved or improved arterial stenosis was noted in 27 (55%), and symptomatic recurrent ischemic stroke in 2 (4%). Among patients with CVT, complete or partial recanalization was noted in 25 (90%), and no significant functional disability in 26 (93%). No patient developed intracranial hemorrhage.
CONCLUSIONS
Although no statistical conclusions can be drawn from these data, DOA could be an alternative in patients with CAD-related embolic infarct and CVT-related hemorrhagic venous infarct. A large-scale clinical trial will be needed to validate these results.
背景
迄今为止，关于直接口服抗凝剂（DOA）在颈动脉夹层（CAD）和脑静脉血栓形成（CVT）患者中的应用效果知之甚少。我们介绍了我们在 CAD 和 CVT 中使用 DOA 的初步经验，并概述了已发表的文献。
方法
从我们的数据库中，我们确定了 4 例 CAD 后和 4 例 CVT 后接受 DOA 治疗的患者。此外，我们还分析了文献综述中报告的 45 例 CAD 后和 23 例 CVT 后接受 DOA 治疗的患者的数据。
结果
在 CAD 患者中，27 例（55%）动脉狭窄得到缓解或改善，2 例（4%）出现症状性复发性缺血性卒中。在 CVT 患者中，25 例（90%）完全或部分再通，26 例（93%）无明显功能障碍。无患者发生颅内出血。
结论
尽管不能从这些数据中得出统计学结论，但 DOA 可能是 CAD 相关栓塞性梗死和 CVT 相关出血性静脉梗死患者的一种替代治疗方法。需要进行大规模临床试验来验证这些结果。
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