Huang Wendy, Du Rose
Department of Medicine, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, 14445 Olive View Drive, Sylmar, CA, United States.
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, United States.
J Clin Neurosci. 2019 Feb;60:31-35. doi: 10.1016/j.jocn.2018.10.001. Epub 2018 Oct 24.
Several clinical trials in cerebrovascular neurosurgery were published during 2016-2017. The Collaborative Unruptured Endovascular versus Surgery Trial (CURES) found no difference in outcome between clipping versus coiling of unruptured aneurysms after one year. The Flow Diversion in the Treatment of Intracranial Aneurysm Trial (FIAT) was terminated due to safety concerns. Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity after Subarachnoid Hemorrhage Trial (NEWTON) and other trials demonstrated no improvement in outcome for vasospasm. The Duration of Prophylaxis after Subarachnoid Hemorrhage Trial (DOPAST) did not show benefit for extended seizure prophylaxis. Minimally Invasive Surgery plus Alteplase in Intracerebral Hemorrhage Evacuation Trial (MISTIE) reported a new strategy for treating intracerebral hemorrhage. A hemorrage site analysis from the Japan Adult Moyamoya Trial (JAM) was presented. The 10-year results from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) and the new Asymptomatic Carotid Trial I (ACT I) were reported. Lastly, findings from six ischemic stroke trials were presented.
2016年至2017年期间发表了多项脑血管神经外科领域的临床试验。未破裂颅内动脉瘤血管内治疗与手术协作试验（CURES）发现，未破裂动脉瘤夹闭术与血管内栓塞术在术后一年的疗效上没有差异。颅内动脉瘤血流导向治疗试验（FIAT）因安全问题而终止。蛛网膜下腔出血后使用尼莫地平微粒增强恢复并降低毒性试验（NEWTON）及其他试验表明，血管痉挛的疗效没有改善。蛛网膜下腔出血后预防持续时间试验（DOPAST）未显示延长癫痫预防有任何益处。脑出血微创清除术联合阿替普酶试验（MISTIE）报告了一种治疗脑出血的新策略。日本成人烟雾病试验（JAM）展示了一项出血部位分析。报告了颈动脉血运重建内膜切除术与支架置入术试验（CREST）的10年结果以及新的无症状颈动脉试验I（ACT I）。最后，介绍了六项缺血性中风试验的结果。
