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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Mechanical Thrombectomy for Patients with In-Hospital Ischemic Stroke: A Case-Control Study
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Mechanical Thrombectomy for Patients with In-Hospital Ischemic Stroke: A Case-Control Study

机译：患有医院缺血性脑卒中患者的机械血栓切除术：案例对照研究

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Background and Aim: Patients with in-hospital acute ischemic stroke (AIS) have, in general, worse outcomes compared to those presenting from the community, partly attributed to the numerous contraindications to intravenous thrombolysis. We aimed to identify and analyze a group of patients with in-hospital AIS who remain suitable candidates for acute endovascular therapies. Methods: A retrospective 6-year data analysis was conducted in patients evaluated through the in-hospital stroke alert protocol in a single tertiary care university hospital to identify those with in-hospital AIS due to acute intracranial large vessel occlusion (ILVO). Feasibility and safety of mechanical thrombectomy for in-hospital AIS was assessed in a case-control study comparing inpatients to those presenting from the community. Results: From 1460 in-hospital stroke alert activations, 11% had a final diagnosis of AIS (n = 167). One hundred and two patients with in-hospital AIS had emergent intracranial vessel imaging and were included in our cohort. Acute ILVO was identified in 27 patients within this cohort. Patients were younger in the ILVO group and had more severe neurologic deficit on presentation. Compared to a matched (1:2) control group of patients presenting from the community, inpatients who underwent mechanical thrombectomy achieved equivalent technical success, safety, and clinical outcomes. Conclusions: The incidence of acute ILVO in patients with in-hospital AIS who underwent emergent vessel imaging is similar to the reported incidence of ILVO in patients presenting with community-onset AIS. Among patients with in-hospital AIS secondary to ILVO, mechanical thrombectomy is a feasible and safe therapy associated with favorable outcomes.
机译：背景与目的：与社区患者相比，院内急性缺血性卒中（AIS）患者的预后通常更差，部分原因是静脉溶栓有许多禁忌证。我们的目的是确定和分析一组仍然适合急性血管内治疗的住院AIS患者。方法：对一所三级护理大学医院通过院内卒中预警方案评估的患者进行6年回顾性数据分析，以确定因急性颅内大血管闭塞（ILVO）而出现院内AIS的患者。在一项病例对照研究中，对住院患者和社区患者进行了比较，评估了机械血栓切除术治疗住院AIS的可行性和安全性。结果：在1460次院内卒中警报激活中，11%的患者最终诊断为AIS（n=167）。102例院内AIS患者进行了紧急颅内血管成像，并被纳入我们的队列。在该队列中的27名患者中发现了急性ILVO。ILVO组的患者更年轻，出现更严重的神经功能缺损。与来自社区的匹配（1:2）对照组患者相比，接受机械血栓切除术的住院患者取得了同等的技术成功、安全性和临床效果。结论：接受急诊血管成像的住院AIS患者中急性ILVO的发生率与社区发病AIS患者中ILVO的报告发生率相似。在ILVO继发的院内AIS患者中，机械血栓切除术是一种可行且安全的治疗方法，具有良好的疗效。

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