百岁患者 2 例急性缺血性脑卒中机械取栓的安全性和疗效。
Safety and Efficacy of Mechanical Thrombectomy in 2 Cases of Acute Ischemic Stroke in Centennial Patients.
机构信息
Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
出版信息
World Neurosurg. 2019 Jul;127:362-365. doi: 10.1016/j.wneu.2019.04.123. Epub 2019 Apr 19.
BACKGROUND
Mechanical thrombectomy (MT) became a standard of care for stroke patients after the positive results of 5 randomized trials in 2015. However, elderly patients >65 were excluded from those trials. Recent studies and clinical trials examining the efficacy of MT in patients older than the age of 85 have shown that good outcomes can be achieved with careful patient selection.
CASE DESCRIPTION
Two patients older than the age of 100 who presented with stroke were treated with MT. Although the cases were different in baseline neurologic status, surgical history, and gender, both achieved successful procedures.
CONCLUSION
We believe that MT in centennials is technically safe and effective and should be considered. In this age group a careful assessment of existing medical condition and a thorough discussion with the family about goals of care is of paramount importance to optimize clinical outcomes.
背景
2015 年 5 项随机试验的积极结果公布后，机械取栓（MT）成为中风患者的标准治疗方法。然而，这些试验将年龄>65 岁的老年患者排除在外。最近的研究和临床试验检查了 MT 在 85 岁以上患者中的疗效，结果表明，通过仔细选择患者，可以获得良好的结果。
病例描述
2 名年龄超过 100 岁的中风患者接受了 MT 治疗。尽管这两例患者的基线神经状态、手术史和性别不同，但都成功完成了手术。
结论
我们认为，百岁老人的 MT 在技术上是安全有效的，应予以考虑。在这个年龄段，仔细评估现有医疗状况，并与家属充分讨论治疗目标，对于优化临床结果至关重要。
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