% 0期刊文章%哈哈林%一个飞凤刘张郝% %一个陈陈% Chushuang陈% Andrew Bivard %李刚马克•帕森斯(george w . bush) % %的激发% T桥接之前血管内溶栓治疗中风患者更快的核心增长% D R 10.1212 / WNL 2023%。0000000000207154 % J半岛投注体育官网神经病学% P e2083-e2092 % V 100% N 20% X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。核心增长率分为快速(> 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。主要的结果是0 - 2改良Rankin规模在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的溶栓再灌注2酮和时间从腹股沟穿刺。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。弥合溶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 - -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 - -1.87),p = 0.989)。患者的核心快速增长,缩小和直接EVT患者未表现出不同再灌注率(80%比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 %U //www.ebmtp.com/content/neurology/100/20/e2083.full.pdf