侧枝循环招聘和失败在急性缺血性中风患者静脉rTPA。(P3.102)

文摘

背景:侧枝循环招募提供替代途径维持血液供应在急性缺血性中风(AIS);然而络脉的演变在很大程度上是未知的。我们现有方法相比得分络脉评估抵押品招聘的影响与AIS患者IV-rTPA和失败。方法:我们包括125名计算机断层血管造影患者静脉rTPA之前和之后执行。颅内络脉进行评估通过5 2独立盲神经放射预定义的标准——Miteff系统成绩MCA抵押品分支对大脑侧裂;马斯河系统比较络脉与影响;modified-Tan的规模,络脉蠅MCA领土的50%被归类为好;一个20分的抵押品分级方法对应地区方面。5系统修改方面方法变成14分皮质和内部脑静脉(ICV)评分系统。良好的功能结果在不到三夫人由0 - 1的分数。 Symptomatic bleed was defined as intracranial haemorrhage which caused NIHSS to fall by 蠅4. Results: Recruitment of collaterals based on the Miteff scoring system showed a trend to better outcomes (OR 2.214 95%CI 0.937-4.862,p=0.63). On univariate analysis collateral recruitment via the Tan scoring system, ASPECTS score improvement of 蠅 6, Cortical and ICV score 蠅 7, hypertension and a higher NIHSS score were associated with symptomatic bleeds. On multivariate analysis only collateral recruitment on the Tan scoring system (OR 3.389 95%CI 1.009-12.025,p =0.045), Collateral recruitment on ASPECTS methodology 蠅 6 (OR 2.940 95%CI 1.054- 7.896,p = 0.032) and collateral recruitment on the cortical and ICV scoring system 蠅 7 (OR 4.204 95%CI 1.200-14.161,p = 0.022) were significantly associated with symptomatic bleed. Collateral failure did not show any association with poorer outcomes or bleeding. Conclusion: substantial recruitment of collaterals is strongly associated with symptomatic bleeding after treatment with IV-rTPA.

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