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Safety, feasibility, and potential efficacy of intraarterial selective cooling infusion for stroke patients treated with mechanical thrombectomy

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机构: [1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China [2]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [3]Department of Neurointerventional Surgery, Hartford Hospital, Hartford, CT, USA [4]Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA [5]Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China [6]Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China [7]Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China [8]China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
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关键词: Hypothermia endovascular procedures neuroprotection intra-arterial infusions reperfusion injury

摘要:
This is a prospective non-randomized cohort study of 113 consecutive patients to investigate the safety and efficacy of a short-duration intraarterial selective cooling infusion (IA-SCI) targeted into an ischemic territory combined with mechanical thrombectomy (MT) in patients with large vessel occlusion-induced acute ischemic stroke (AIS); 45/113 patients underwent IA-SCI with 350 ml 0.9% saline at 4celcius for 15 min at the discretion of the interventionalist. Key parameters such as vital signs and key laboratory values, symptomatic and any intracranial hemorrhage, coagulation abnormalities, pneumonia, urinary tract infections and mortality were not significantly different between the two groups. Final infarct volume (FIV) was assessed on noncontrast CT performed at three to seven days. After an adjusted regression analysis, the between-group difference in FIV (19.1 ml; 95% confidence interval (CI) 3.2 to 25.2; P = 0.038) significantly favored the IA-SCI group. At 90 days, no differences were found in the proportion of patients who achieved functional independence (mRS 0-2) (51.1% versus. 41.2%, adjusted odd ratio (aOR) 1.9, 95% CI 0.8-2.6, P = 0.192). Combining short-duration IA-SCI with MT was safe. There was a smaller FIV and trend towards clinical benefit that will need to be further evaluated in randomized control trials.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢 2 区 血液学 2 区 神经科学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢 2 区 血液学 2 区 神经科学
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出版当年[2016]版:
Q1 ENDOCRINOLOGY & METABOLISM Q1 HEMATOLOGY Q1 NEUROSCIENCES
最新[2023]版:
Q1 ENDOCRINOLOGY & METABOLISM Q1 HEMATOLOGY Q1 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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通讯机构: [*1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 of Changchun Street, Beijing, China.
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