颅内动脉瘤支架辅助血管内治疗 24 小时后血液生化血栓形成参数的变化。

IF 1.7 4区 医学 Q3 Medicine Interventional Neuroradiology Pub Date : 2024-08-08 DOI:10.1177/15910199241272522
Celal Cinar, Ismail Oran, Halil Ibrahim Ozdemir, Mahmut Kusbeci, Ramazan Kaan Kavakli, Mahmut Tobu, Zuhal Parildar
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引用次数: 0

摘要

背景和目的:本研究旨在阐明支架辅助血管内治疗颅内动脉瘤后血液生化血栓形成参数的早期变化:经当地伦理委员会批准,本前瞻性研究纳入了在血管内治疗过程中接受支架植入术的连续性未破裂动脉瘤患者。在手术前和手术后 24 小时采集血液样本进行生化分析,包括血栓形成基本指标、出血检查和全血细胞计数:研究包括 80 名患者(60 名女性,20 名男性),共 134 个动脉瘤。共使用了 135 个支架(110 个分流支架,25 个标准支架)。此外,还对 27 名患者中的 28 个动脉瘤进行了肌内卷曲治疗。术后,所有患者的活化部分凝血活酶时间、纤维蛋白原、血红蛋白和血小板水平均显著下降,凝血酶原时间、D-二聚体、von Willebrand因子(vWF)活性/抗原比值和白细胞水平显著上升。相关分析表明,在线圈(-)组中,血小板和纤维蛋白原水平之间存在明显的正相关,D-二聚体和纤维蛋白原水平之间存在负相关。此外,动脉瘤体积与 vWF 活性/抗原比值、手术时间与血小板计数之间呈显著负相关,而在线圈(-)组中,动脉瘤数目与白细胞计数之间呈正相关:血液化学变化分析表明,支架辅助血管内治疗颅内动脉瘤后,颅内循环中会出现血管内血栓形成。这种血栓形成过程在动脉瘤保持开放(即仅使用分流支架)的患者中更为明显。
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Changes in blood biochemistry thrombosis parameters 24 hours after stent-assisted endovascular treatment of intracranial aneurysms.

Background and purpose: This study aims to elucidate the early changes in blood biochemistry thrombosis parameters following stent-assisted endovascular treatment of intracranial aneurysms.

Methods: Consecutive patients with unruptured aneurysms undergoing stent implantation during endovascular treatment were included in this prospective study with approval from the local ethics committee. Blood samples were collected immediately before and 24 h after the procedure for biochemical analysis, including basic thrombosis indicators, bleeding tests, and a complete blood count.

Results: The study included 80 patients (60 women, 20 men) with 134 aneurysms. A total of 135 stents (110 flow-diverting, 25 standard) were used. Additionally, intrasaccular coiling was utilized in 28 aneurysms among 27 patients. Following the procedure, there was a significant decrease in activated partial thromboplastin time, fibrinogen, hemoglobin, and platelet levels, and a significant increase in prothrombin time, D-dimer, von Willebrand factor (vWF) activity/antigen ratio, and leukocyte levels in all patients. Correlation analyses revealed significant positive associations between platelet and fibrinogen levels, and a negative association between D-dimer and fibrinogen levels in the coil (-) group. Additionally, there was a significant negative correlation between aneurysm volume and vWF activity/antigen ratio, and procedure duration and thrombocyte count, while a positive association was found between aneurysm number and leukocyte count in the coil (-) group.

Conclusions: Analysis of blood chemistry alterations indicates that intravascular thrombosis occurs in the intracranial circulation following stent-assisted endovascular treatment of intracranial aneurysms. This thrombotic process is more pronounced in patients whose aneurysms were left open (i.e. flow-diverting stent alone).

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来源期刊
CiteScore
2.80
自引率
11.80%
发文量
192
审稿时长
6-12 weeks
期刊介绍: Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...
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