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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Stroke- on- Awakening: Safety of CT-CTA Based Selection for Reperfusion Therapy
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Stroke- on- Awakening: Safety of CT-CTA Based Selection for Reperfusion Therapy

机译：中风唤醒：基于CT-CTA的再灌注治疗选择的安全性

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Background: We studied the safety of use of acute reperfusion therapies in patients with stroke- on- awakening using a computed tomographic angiography (CIA) based large vessel occlusion-good scan paradigm in clinical routine. Methods: The CTA database of the Calgary stroke program was reviewed for the period January 2003-March 2010. Patients with stroke-on-awakening with large artery occlusions on CIA, who received conservative, IV thrombolytic and/or endovascular treatment at discretion of the attending stroke neurologist were analyzed. Time of onset was defined by the time last seen or known to be normal. Baseline non-contrast CT scan (NCCT) Alberta Stroke Program Early CT Score (ASPECTS) > 7 was considered a good scan. Hemorrhage was defined on follow-up brain imaging using ECASS 3 criteria. Independence (mRS <= 2) at three months was considered a good clinical outcome. Standard descriptive statistics and multivariable analysis were done. Results: Among 532 patients with large artery occlusions. 70 patients with stroke-on-awakening (13.1%) were identified. The median age was 69.5 (IQR 24) and 41(58.6%) were female: 41(58.6%) received anti-platelets only and 29(41.4%) received thrombolytic treatment [IV-12 (17.1%), IV/IA-12 (17.1%) and IA-5(7.1%)]. Unadjusted analysis showed that baseline NCCT ASPECTS <= 7 (p=0.002) and higher NIHSS scores (p=0.018) were associated with worse outcomes. There were no PH2 hemorrhages in the IV thrombolytic or endovascular treated group. Functional outcome was not different by treatment. Conclusion: When carefully selected using CT -CIA, by a good scan (ASPECTS > 7) occlusion paradigm, acute reperfusion therapies in patients with stroke-on-awakening can be performed safely in clinical routine.
机译：背景：我们研究了基于计算机断层血管造影（CIA）的大血管闭塞-良好扫描范例在临床常规中对急性卒中患者使用急性再灌注疗法的安全性。方法：回顾了2003年1月至2010年3月期间卡尔加里中风计划的CTA数据库。CIA的醒来性中风伴大动脉闭塞的患者可酌情接受保守，静脉溶栓和/或血管内治疗。主治中风神经科医生进行了分析。发作时间由上次见到或已知为正常的时间定义。基线非造影CT扫描（NCCT）艾伯塔中风计划早期CT分数（ASPECTS）> 7被认为是良好的扫描。出血是根据ECASS 3标准在随访脑成像中定义的。三个月的独立性（mRS <= 2）被认为是良好的临床预后。完成标准描述性统计和多变量分析。结果：在532例大动脉闭塞患者中。确定了70例唤醒中风患者（13.1％）。中位年龄为69.5（IQR 24），女性为41（58.6％）：41（58.6％）仅接受抗血小板治疗，29（41.4％）接受了溶栓治疗[IV-12（17.1％），IV / IA- 12（17.1％）和IA-5（7.1％）]。未经校正的分析表明，基线NCCT ASPECTS <= 7（p = 0.002）和更高的NIHSS评分（p = 0.018）与较差的预后相关。静脉溶栓治疗或血管内治疗组没有PH2出血。通过治疗，功能结局没有差异。结论：当使用CT -CIA仔细选择时，通过良好的扫描（ASPECTS> 7）闭塞范例，可以在临床常规中安全地对唤醒中风患者进行急性再灌注治疗。

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