探讨血管内介入治疗在钝性颈动脉和椎动脉创伤中的作用。
Exploring the role of endovascular interventions in blunt carotid and vertebral artery trauma.
机构信息
Scripps Memorial Hospital La Jolla, 9888 Genesee Ave., LJ601, La Jolla, CA, 92037, USA.
出版信息
Am J Surg. 2023 Nov;226(5):688-691. doi: 10.1016/j.amjsurg.2023.07.030. Epub 2023 Jul 24.
BACKGROUND
The role of endovascular interventions (EI) for blunt carotid and vertebral artery injuries (BCI and BVI) is poorly defined. The purpose of this study was to assess the efficacy of EI compared with antithrombotic therapy (AT) to inform future prospective study.
METHODS
Retrospective review (2017-2022) of records at a Level I trauma center to determine injury, treatment, and outcome information. Primary outcome was stroke.
RESULTS
96 patients suffered 106 injuries (74 BVI, 32 BCI). 12 patients underwent 13 EI- 4 therapeutic, 9 prophylactic. Stroke occurred in 12 patients- 6 who had EI. In grade IV BVI, stroke rates are low with both EI and AT. Thrombectomy after stroke improved neurologic function in 4 (100%) of 4 patients.
CONCLUSIONS
Most strokes occur prior to preventive therapy. Neither AT nor EI is 100% effective in preventing stroke. Thrombectomy may improve neurologic outcomes after stroke. Prospective multicenter study is imperative.
背景
血管内介入治疗（EI）在钝性颈动脉和椎动脉损伤（BCI 和 BVI）中的作用尚未明确。本研究旨在评估 EI 与抗血栓治疗（AT）的疗效，为未来的前瞻性研究提供信息。
方法
回顾性分析（2017-2022 年）一家一级创伤中心的记录，以确定损伤、治疗和结果信息。主要结局是中风。
结果
96 名患者发生 106 处损伤（74 处 BVI，32 处 BCI）。12 名患者接受了 13 次 EI 治疗，其中 4 次为治疗性，9 次为预防性。12 名患者发生中风，其中 6 名患者接受了 EI。在 IV 级 BVI 中，EI 和 AT 的中风发生率均较低。中风后进行血栓切除术可使 4 名患者（100%）的神经功能得到改善。
结论
大多数中风发生在预防治疗之前。AT 和 EI 均不能 100%预防中风。血栓切除术可能改善中风后的神经功能预后。有必要开展多中心前瞻性研究。
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