JAMA Neurol:颅内动脉瘤预防性治疗人群临床并发症风险评估

2019-01-02 zhangfan MedSci原创

本研究,首次系统性的对未破裂颅内动脉瘤预防性治疗后患者临床并发症风险因素进行了评估,对临床具有极高的指导意义

目前未破裂颅内动脉瘤在预防性治疗后,患者临床并发症的风险和病死率(CFR)因治疗方式和危险因素存在差异。近日研究人员考察了血管内治疗(EVT)和神经外科治疗(NST)对患者并发症及死亡率的影响。

本次研究为系统综述及荟萃分析研究,2011-17年的相关研究为本研究的考察内容,研究的主要终点为临床并发症及死亡率。

114个研究纳入本次荟萃分析,包含106443名患者,总计108263个动脉瘤。对于接受EVT的人群,累积的临床并发症风险为4.96%,CFR为0.30%,其中女性(OR=1.06)、糖尿病(1.81)、高血脂(1.76)、心脏疾病(2.27)、宽动脉瘤颈(>4mm或圆顶颈比>1.5;1.71)、后循环动脉瘤(1.42)、辅助螺旋支架(1.82)和支架置入术(3.43)人群接受EVT后不良事件风险增加。对于NST人群,累积并发症风险为8.34%,CFR为0.10%,其中高龄(每1年OR=1.02)、女性(0.42)、凝血病(2.14)、抗凝药(6.36)、吸烟(1.95)、高血压(1.45)、糖尿病(2.38)、充血性心力衰竭(2.71)、后动脉瘤 (7.25)和动脉瘤钙化(2.89)人群接受NST后不良事件风险增加。

本研究,首次系统性的对未破裂颅内动脉瘤预防性治疗后患者临床并发症风险因素进行了评估,对临床具有极高的指导意义。

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    2019-09-15 丁鹏鹏
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    2019-10-15 yinhl1978
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    2019-01-02 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2019-01-02 医者仁心5538

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