颅内狭窄的治疗管理的趋势和Post-Sammpris时代(P1.146)

文摘

背景:治疗颅内狭窄已经发展在过去的2年。这个调查试图定义的影响,支架和激进的医疗管理对预防复发性中风颅内狭窄(SAMMPRIS)”的nih资助的专门医师的临床试验治疗趋势管理颅内狭窄。治疗方法:调查选择了1年出版的SAMMPRIS试验结果。(2012)。类似的调查设计后华法林和阿司匹林症状性颅内疾病(WASID)审判时期,另一个nih资助的专门的临床试验是用来比较治疗趋势(pre-SAMMPRIS调查)。调查都被送到神经病学家以及neurointerventionists。post-SAMMPRIS调查解决问题的最大好处医生需要推荐一个新的血管内治疗他们的病人。使用卡方测试数据进行了分析。结果:Post-SAMMPRIS,受访者推荐抗血小板治疗颅内狭窄的数量增加。post-WASID / pre-SAMMPRIS受访者相比,更多post-SAMMPRIS受访者狭窄的首选抗血小板药物前循环(85%比94%,p = 0.0017)和后循环(74%比83%,p = 0.0145)。 The antiplatelet agent most post-SAMMPRIS was the combination of aspirin and clopidogrel. The percentage of neurologists who recommended percutaneous transluminal angioplasty and stenting (PTAS) in > 25% of ICAS patients decreased from pre-SAMMPRIS (12%) to post-SAMMPRIS (6%), while for neurointerventionists, it decreased from (49%) to (17%). DISCUSSION: SAMMPRIS had a major impact on treatment trends of physicians managing patients with intracranial stenosis. In the Post-SAMMPRIS survey, 91% of respondents participating in SAMMPRIS and 82% of overall respondents indicated that the SAMMPRIS results changed the way they managed patients with ICAS.As aggressive medical management coupled with optimal risk factor reduction shows promise in reducing rates of recurrent stroke, a novel endovascular therapy will have to seek newer heights of increasing RRR to gain acceptance by practitioners.

披露:帕瓦尔博士没有披露。图兰获得了博士个人补偿活动与戈尔实验室Inc .和勃林格殷格翰集团制药公司。图兰获得了博士研究Stryker有限公司的支持,美国国立卫生研究院和阿斯利康。Cotsonis博士没有披露。林恩博士没有披露。伍力博士没有披露。斯特恩博士已经收到个人活动与补偿Lippincott威廉姆斯和威尔金斯。斯特恩博士已经收到个人神经学家在一篇社论中补偿能力。Derdeyn博士已经收到个人活动与补偿戈尔公司和同事,波士顿科技公司和目标疗法。博士工作程序已经收到个人活动与补偿Covidien / ev3,科德曼/ Micrus / johnson & johnson, NFocus,血管仿真,CSVL Microvention /作秀的成分,和西门子医疗成像。博士工作程序收到了皇室,执照费或合同权利支付从科德曼/ Micrus /公司。 Dr. Fiorella has received research support from Microvention and Siemens Medical Imaging. Dr. Chimowitz has received personal compensation for activities with Axio Research, Merck & Co. Inc., and Gore. Dr. Chimowitz has received research support from the National Institute of Neurological Disorders and Stroke, Stryker, and Boston Scientific Corporation.