急性缺血性腦卒中血管成形術(shù)(英文)-在線瀏覽
2024-11-21 06:31本頁面
【正文】 e catheter Requires interventionalist Emergent availability of angiography,PROACT II,Randomized multicenter controlled trial 9 mg IA rproUK + IV heparin v. IV heparin alone Randomized 2:1 to treatment v. control 180 pts with M1 or M2 occlusion by angio Treatment started within 6 hours of stroke onset IA rproUK infused over 2 hours then repeat angio Primary endpoint mRS ≤ 2 at 90 days,PROACT II: 90 DAY OUTCOMES Intent to Treat,PROACT II: MCA RECANALIZATION,4%,19%,2%,63%,66%,18%,TIMI 2+3,TIMI 3,( P= .001 ),( P=.003),ANGIOGRAM,IMS TRIAL Design,Eligible patients,Start IV tPA – entry into study,(0.6 mg/kg, 15% bolus, 30 min inf., 60 mg max.),Angiography,Thrombus,No clot – stop,Clot – IA Therapy: 2 mgdistal, 2 mgintraclot, 9 mg/hr x 2 hrs, 22 mg max.),Favorable Outcome at 3 months (%)*,*Adjusted for baseline NIHSS and timetotreatment,IMS Safety,Issues with IA Chemical Lysis,Time consuming to dissolve clot May be ineffective with long segments of clot Platelet rich/Plasminogen poor clots resistant to IA thrombolysis,Mechanical thrombolysis,Merci Retrieval Device,MERCI trial,Study to determine the safety and potential efficacy of the MERCI clot retriever device in patients with cerebral artery occlusion 8 hours (MCA, ICA or basilar) Clinical signs consistent with the diagnosis of ischemic stroke Must meet either population 03 hours, contraindicated for IV tPA 38 hours NIHSSS ≥ 8 Angiogram shows a thrombotic occlusion in the internal carotid artery, M1 and/or M2 segment of the middle cerebral artery, basilar or vertebral artery,A total of 151 patients enrolled and 141 treated with MERCI device The overall recanalization rate with the device was 48% this was significantly higher then control arm of PROACT II Clinically significant procedural complications were 7.1% Symptomatic ICH occurred in 7.8% of patients Recanalization rate was l
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鄂ICP備17016276號-1