急性基底动脉闭塞血管内治疗中辐射暴露：配对分析。
Radiation exposure in endovascular stroke treatment of acute basilar artery occlusions-a matched-pair analysis.
机构信息
Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
出版信息
Neuroradiology. 2020 Dec;62(12):1701-1707. doi: 10.1007/s00234-020-02490-0. Epub 2020 Jul 10.
PURPOSE
To determine the radiation exposure in endovascular stroke treatment (EST) of acute basilar artery occlusions (BAO) and compare it with radiation exposure of EST for embolic middle cerebral artery occlusions (MCAO).
METHODS
In this retrospective analysis of an institutional review board-approved prospective stroke database of a comprehensive stroke center, we focused on radiation exposure (as per dose area product in Gy × cm, median (IQR)), procedure time, and fluoroscopy time (in minutes, median [IQR]) in patients receiving EST for BAO. Patients who received EST for BAO were matched case by case with patients who received EST for MCAO according to number of thrombectomy attempts, target vessel reperfusion result, and thrombectomy technique.
RESULTS
Overall 180 patients (n = 90 in each group) were included in this analysis. General anesthesia was conducted more often during EST of BAO (BAO: 75 (83.3%); MCAO: 18 (31.1%), p < 0.001). Procedure time (BAO: 31 (20-43); MCAO: 27 (18-38); p value 0.226) and fluoroscopy time (BAO: 29 (20-59); MCAO: 29 (17-49), p value 0.317) were comparable. Radiation exposure was significantly higher in patients receiving EST for BAO (BAO: 123.4 (78.7-204.2); MCAO: 94.3 (65.5-163.7), p value 0.046), which represents an increase by 23.7%.
CONCLUSION
Endovascular stroke treatment of basilar artery occlusions is associated with a higher radiation exposure compared with treatment of middle cerebral artery occlusions.
目的
确定急性基底动脉闭塞（BAO）血管内治疗（EST）中的辐射暴露，并与大脑中动脉栓塞（MCAO）EST 的辐射暴露进行比较。
方法
在对一家综合卒中中心机构审查委员会批准的前瞻性卒中数据库进行的回顾性分析中，我们重点关注接受 BAO EST 的患者的辐射暴露（剂量面积乘积为 Gy×cm，中位数（IQR））、手术时间和透视时间（以分钟为单位，中位数（IQR））。根据取栓次数、靶血管再通效果和取栓技术，对接受 BAO EST 的患者与接受 MCAO EST 的患者进行了逐个匹配。
结果
本分析共纳入 180 例患者（每组 90 例）。BAO EST 中更常使用全身麻醉（BAO：75（83.3%）；MCAO：18（31.1%），p<0.001）。手术时间（BAO：31（20-43）；MCAO：27（18-38）；p 值 0.226）和透视时间（BAO：29（20-59）；MCAO：29（17-49），p 值 0.317）相似。接受 BAO EST 的患者的辐射暴露明显更高（BAO：123.4（78.7-204.2）；MCAO：94.3（65.5-163.7），p 值 0.046），增加了 23.7%。
结论
与治疗大脑中动脉闭塞相比，基底动脉闭塞的血管内卒中治疗与更高的辐射暴露相关。
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