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大血管闭塞所致早期神经功能恶化的缺血性脑卒中患者挽救性血管内治疗的安全性和有效性

Safety and efficacy of rescue endovascular treatment in ischemic stroke patients with early neurological deterioration caused by large vessel occlusion.

作者信息

Chen Mengmeng, Cao Jun, Li Yao, Yang Weimin, Jia Ruiqi, Wang Shuiping, Liu Yang, Wang Jingye

机构信息

Department of Neurology, The First Affiliated Hospital of Anhui Medical University Hefei, Anhui, China.

Anhui Medical University Hefei, Anhui, China.

出版信息

Am J Transl Res. 2025 May 15;17(5):3766-3777. doi: 10.62347/SHIL2671. eCollection 2025.

Abstract

OBJECTIVES

The optimal treatment after deterioration following ischemic stroke has not been established in the current guidelines. Therefore, this study evaluated the efficacy of rescue endovascular treatment in patients with early neurological deterioration after acute ischemic stroke.

METHODS

This study analyzed data retrospectively retrieved from the electronic medical records at the First Affiliated Hospital of Anhui Medical University.

RESULTS

A total of 20 patients were included in the rescue endovascular treatment group and 23 in the medical group. The 90-day favorable outcome rate in the rescue endovascular treatment group was significantly better than that of the medical group (75.0% 34.8%, =0.031). However, no significant difference in all-cause mortality within 90 days was observed between the rescue endovascular treatment group and the medical group (5.0% 8.7%, =1.000). The 90-day prognosis of patients with mild stroke of anterior circulation and large vessel occlusion who underwent rescue endovascular treatment after deterioration was significantly better than that of those in the medical group (76.5% 31.6%, =0.010).

CONCLUSION

Rescue endovascular treatment is effective and safe for patients with ischemic stroke and deterioration due to large vessel occlusion, leading to no significant increase in the risk of hemorrhage or death even when the time window exceeds 24 h.

摘要

目的

目前的指南尚未确定缺血性卒中病情恶化后的最佳治疗方法。因此,本研究评估了急性缺血性卒中后早期神经功能恶化患者进行挽救性血管内治疗的疗效。

方法

本研究回顾性分析了从安徽医科大学第一附属医院电子病历中检索到的数据。

结果

挽救性血管内治疗组共纳入20例患者,药物治疗组纳入23例。挽救性血管内治疗组90天良好预后率显著高于药物治疗组(75.0%对34.8%,P=0.031)。然而,挽救性血管内治疗组与药物治疗组在90天内的全因死亡率无显著差异(5.0%对8.7%,P=1.000)。病情恶化后接受挽救性血管内治疗的前循环轻度卒中伴大血管闭塞患者的90天预后显著优于药物治疗组(76.5%对31.6%,P=0.010)。

结论

挽救性血管内治疗对因大血管闭塞导致病情恶化的缺血性卒中患者有效且安全,即使时间窗超过24小时,出血或死亡风险也无显著增加。

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