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JAMA Neurol:影像学高风险斑块特征的无症状颈动脉狭窄患者其缺血性脑血管事件风险增加

2020-08-10 MedSci原创 MedSci原创

无症状颈动脉狭窄患者中,存在高风险斑块的患者比例很高,且高风险斑块与同侧缺血性脑血管事件相关

对于无症状颈动脉狭窄患者的治疗,目前仍存在争议。近日研究人员利用高风险斑块影像学特征,对存在高风险斑块的无症状颈动脉狭窄患者缺血性脑血管事件发病率进行评估,建立以风险导向血运重建的相关性和可行性。
 
本次研究为系统综述及荟萃分析,收集截至2019年7月31日相关研究资料,研究的主要终点为高危斑块的患病率和同侧缺血事件的年发生率。
 
64项研究,包含20751名年龄范围为29至95岁的参与者。在所有参与者中,高危斑块的合并患病率为26.5%。最常见的高危斑块特征包括:新生血管(785例)、回声透亮(12364例)以及富含脂质的坏死核心(3728例)。同侧缺血性脑血管事件的总发生率为3.2例/100患者年(22个队列,10381名参与者;平均随访期为2.8年),伴有高危斑块患者同侧缺血性脑血管事件(4.3例/100患者年)的发生率高于无高危斑块患者(1.2例/100患者年),风险比为3.0 ( I2=48.8%)。在以严重狭窄为重点的研究中(9个队列,2128名参与者;平均随访期为2.8年),同侧缺血性脑血管事件的发生率为3.7例/100患者年,高危斑块患者同侧缺血性脑血管事件(7.3例/100患者年)的发生率也高于无高危斑块患者(1.7例/100患者年),风险比为3.2( I2=39.6%)。
 
研究认为,无症状颈动脉狭窄患者中,存在高风险斑块的患者比例很高,且高风险斑块与同侧缺血性脑血管事件相关。
 
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encodeId=50be196e4429b, content=<a href='/topic/show?id=ba21590e1f9' target=_blank style='color:#2F92EE;'>#无症状颈动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59071, encryptionId=ba21590e1f9, topicName=无症状颈动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c279140, createdName=vividelife, createdTime=Tue Feb 16 21:14:41 CST 2021, time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003912, encodeId=da0f200391240, content=<a href='/topic/show?id=1860e938561' target=_blank style='color:#2F92EE;'>#缺血性脑血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79385, encryptionId=1860e938561, topicName=缺血性脑血管事件)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fa4f352, createdName=chenlianhui, createdTime=Wed Sep 02 16:14:41 CST 2020, time=2020-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330156, encodeId=553f133015609, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Wed Aug 12 10:14:41 CST 2020, time=2020-08-12, status=1, ipAttribution=)]
    2020-11-23 yinhl1978
  5. 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  6. 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  7. 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    2020-09-13 466906000_35880212

    学习

    0

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  9. 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2012国际卒中大会:无症状性颈动脉疾病者亦可有后遗症

       无症状性颈动脉疾病患者仍可能因动脉狭窄而发生明显的后遗症。纽约布鲁克林Downstate 医疗中心的Clotilde Balucani博士在国际卒中大会上报告,一项入组330人的单中心前瞻性研究显示,有明显颈动脉狭窄而无卒中或短暂性脑缺血发作(TIA)病史的患者,与无颈动脉疾病者相比有显著的认知功能损害。     &nb

Stroke:无症状性颈动脉狭窄患者颈动脉支架成形术与动脉内膜切除术如何选择?

虽然CAS与CEA的长期结局仍有不确定性,CAS治疗增加的围手术期卒中风险和围手术期卒中或死亡,表明CEA是无症状颈动脉狭窄患者治疗的优先选择。

NEJM:无症状性颈动脉狭窄:支架不劣于动脉内膜切除术

先前的临床试验表明,以捕捉和栓子清除装置进行颈动脉支架置入术(“栓塞保护”)是平均或高风险手术并发症患者的一种有效的替代颈动脉内膜切除术的方法。原始出处:Kenneth Rosenfield,Jon S. Matsumura,Seemant Chaturvedi,Randomized Trial of Stent versus Surgery for Asymptomatic Carotid St

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