@article {Line2083作者={哈哈林和郝主任陈和刘飞凤,陈和陈Chushuang和安德鲁Bivard和马克•帕森斯(george w . bush)和李刚和激发},编辑={和利未,克里斯托弗·r·索兰托,尼尔·j .和Garcia-Esperon,卡洛斯和Miteff,费迪南德和崔菲利普·贝拉和克莱因,盖和O {\ textquoteright} Brien,比利和屠夫,肯尼斯和阳,Jianhong阴,Congguo王,彭和耿于方,气和隋,彝族和陈,Wenhuo程,鑫盾,羌族},title ={桥接之前血管内溶栓治疗中风患者更快的核心增长},体积={100}={20},页面= {e2083——e2092} = {2023}, doi = {10.1212 / WNL。出版商0000000000207154}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标仍然是不确定的,要直接血管内血栓切除术(EVT)会导致相同的结果作为半岛投注体育官网桥静脉溶栓(溶)在急性缺血性患者。本研究旨在探讨缺血性核心增长率是否影响病人结果桥接后直接EVT溶vs。方法这是一个回顾性队列研究基于国际中风灌注成像注册(激励)。它选择接受灌注CT在4.5小时内急性缺血性中风患者中风的发病。直接去EVT的患者比较与那些接受了桥接治疗的早期EVT之前。缺血性急性缺血性核心核心增长率估计的体积在灌注CT除以时间从发病到灌注CT,基于假设缺血性的线性增长模式的核心。核心增长率是分层快速(\ > 15毫升/小时)和慢速(< = 15毫升/小时),根据其与桥接诊断和预测的主要结果。主要结果是改良Rankin规模(0){\ textendash} 2 3个月。次要结果包括血栓切除术成功再灌注所定义的修改在脑梗死溶栓2 b {\ textendash} 3分和从腹股沟穿刺到再灌注时间。激发1221 EVT患者的结果,选择323例患者,其中82例接受直接EVT和241名患者接受溶桥接。桥接诊断与较高的患者良好的临床结果在核心快速增长(39 \ % vs 7 \ %直接EVT,优势比8.75[或][1.96 {\ textendash} 39.1], p = 0.005),但是差异不明显的患者核心增长缓慢(55 \ % vs 55 \ %直接EVT,或1.00 0.53 {\ textendash} 1.87, p = 0.989)。患者的核心快速增长,缩小和直接EVT病人显示,再灌注率没有差别(80 \ % vs 76 \ %, p = 0.616)。 However, patients who received bridging IVT were more likely to achieve reperfusion earlier (the median groin to reperfusion time of 63.0 vs 94.0 minutes, p = 0.005).Discussion Patients with fast core growth were more likely to benefit from bridging IVT. This is likely because prior IVT facilitates clot removal and thus reduces time to reperfusion.CTA=CT angiography; CTP=CT perfusion; EVT=endovascular thrombectomy; INSPIRE=International Stroke Perfusion Imaging Registry; IVT=IV thrombolysis; mTICI=modified TICI; NCCA=noncontrast CT; OR=odds ratio; PH=parenchymal hematoma; sICH=symptomatic intracranial hemorrhage; TICI=Thrombolysis in Cerebral Infarction}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/100/20/e2083}, eprint = {//www.ebmtp.com/content/100/20/e2083.full.pdf}, journal = {Neurology} }