神经系统患者的抗血小板、抗凝和选择性动脉瘤治疗

Anjali Patel, Daisy Valle, Drashti Patel, Marco Foreman, Akash Nijhawan, Devon Foster, Alexander Nguyen, Brandon Lucke-Wold
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摘要

对神经系统疾病(如动脉瘤、动静脉畸形和中风)开展更专业的护理可以彻底改变患者的医疗保健和结果。随着外科手术技术的出现,如分流、非支架和支架辅助盘绕、导管栓塞等用于神经系统患者的选择性动脉瘤治疗,与动脉瘤相关的不良反应和发病率可以减少。本文旨在突出新出现的技术的三个具体优点和缺点。血流转移装置包括在母动脉内放置支架,而Woven EndoBridge栓塞包括在不使用双重抗血小板治疗的情况下对动脉壁进行操作。除动脉瘤治疗外,抗血小板和抗凝剂的使用有助于破坏凝血级联。正如美国心脏协会发布的新的和增强的指南所述,如果患者的缺血性严重程度较低,双抗凝剂的施用是有益的。了解与每种治疗相关的各种益处和并发症可以使临床医生深入了解不同患者的潜在治疗轨迹。
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Antiplatelet, anticoagulation, and elective aneurysm treatments in neurological patients
Developing more specialized care for neurological disorders, such as aneurysms, arteriovenous malformations, and strokes, can revolutionize patient healthcare and outcomes. With the advent of surgical techniques such as flow diversion, non-stent- and stent-assisted coiling, and catheter embolization for elective aneurysm treatment in neurological patients, the adverse effects and morbidities associated with aneurysms can be reduced. This paper aims to highlight three specific strengths and weaknesses of the newly emerged techniques. Flow diversion devices involve placing a stent in the parent artery, whereas Woven EndoBridge embolization involves manipulation of the wall of the artery without the administration of dual-antiplatelet therapy. In addition to aneurysm treatment, the administration of antiplatelets and anticoagulants is helpful in disrupting the coagulation cascade. As stated in the new and enhanced guidelines released by the American Heart Association, the administration of dual anticoagulants is beneficial to the patients if they have low ischemic severity. Understanding the various benefits and complications associated with each treatment can allow clinicians to gain insight into the potential trajectory of treatment for different patients.
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