Department of Neurology, Mayo Clinic Rochester, 200 First St SW, Rochester, MN, 55905, USA.
Curr Cardiol Rep. 2017 Oct 18;19(12):122. doi: 10.1007/s11886-017-0931-1.
This study aims to review the current epidemiology and clinical management of patients with cavernous malformations (CM).
Hemorrhage is the most feared complication and leads to morbidity in patients with CM. Multiple studies including three meta-analyses have provided useful estimates of hemorrhage risk, but have failed to identify a modifiable risk factor for prevention of cavernous malformation related hemorrhage. In treating the CM itself, surgical risk is weighed against the natural history. However, accumulating knowledge regarding the roles of CCM 1, 2, and 3 genes has led to the discovery of potential therapeutic targets. The risk of future hemorrhage in patients with CM is highest in those who have had previously clinical hemorrhages. Estimated risks are helpful in counseling patients and comparing to the risk of surgery. Future clinical trials of candidate medications are likely to target those patients with prior clinical hemorrhage in whom the surgical risk is deemed high.
本研究旨在综述海绵状血管畸形（CM）患者的当前流行病学和临床管理。
出血是最令人恐惧的并发症，导致 CM 患者发病。多项研究，包括 3 项荟萃分析，为出血风险提供了有用的估计，但未能确定可预防海绵状血管畸形相关出血的可改变风险因素。在治疗 CM 本身时，需要权衡手术风险与自然病史。然而，关于 CCM1、2 和 3 基因作用的知识不断积累，导致发现了潜在的治疗靶点。有过临床出血史的 CM 患者发生未来出血的风险最高。估计风险有助于为患者提供咨询，并与手术风险进行比较。针对候选药物的未来临床试验可能针对那些先前有临床出血史且手术风险较高的患者。
