过去七十年来,心导管插入术一直安全进行,并发症罕见。主要并发症包括心肌梗死、中风和死亡,发生率不到 1% [1]。心导管插入术后血管通路并发症的发生率因研究人群而异。介入手术的经股动脉通路并发症通常高于诊断手术,这可能与抗凝治疗和鞘管直径有关。据报道,在接受诊断性和介入性心脏手术的患者中,血肿、假性动脉瘤和动静脉瘘等经股动脉通路并发症的发生率为 0% 至 17% [2]。我们的患者在术后一周出现阴囊肿胀,超声检查显示有附睾炎和反应性鞘膜积液。
缩写acoma =前交流动脉; Afr =孔圆形的动脉; apha =上升咽动脉; BMS =裸机支架; BTO =气球测试阻塞; CCA =海绵状颈动脉瘤; DAPT =双重抗血小板治疗; des =洗脱支架; DSA =数字减法血管造影; EC =颅外; ECA =外部颈动脉; ic =颅内; ICA =内部颈动脉; MRI =磁共振成像; NBCA = N-丁基-2-丙烯丙烯酸酯; PCI =经皮冠状动脉干预; pcoma =后验交流动脉; SPECT =单光子发射计算机断层扫描; TAE =经导管动脉栓塞; Vag =椎动脉血管造影。包括2025年2月24日发表的援引; doi:10.3171/case2469 3。于2024年10月7日提交。接受于2024年12月3日。
摘要 背景 脑动脉瘤破裂引起的蛛网膜下腔出血是发病率和死亡率的主要原因。在自动化系统的帮助下,早期识别动脉瘤可能会改善患者的预后。因此,对使用 CT、MRI 或 DSA 检测脑动脉瘤的人工智能 (AI) 算法的诊断准确性进行了系统评价和荟萃分析。方法 搜索了 MEDLINE、Embase、Cochrane Library 和 Web of Science,直至 2021 年 8 月。资格标准包括使用全自动算法通过 MRI、CT 或 DSA 检测脑动脉瘤的研究。按照系统评价和荟萃分析的首选报告项目:诊断测试准确性 (PRISMA-DTA),使用诊断准确性研究质量评估 2 (QUADAS-2) 评估文章。荟萃分析包括一个双变量随机效应模型,以确定合并敏感性、特异性和受试者工作特征曲线下面积 (ROC-AUC)。PROSPERO:CRD42021278454。结果 纳入 43 项研究,其中 41/43 (95%) 为回顾性研究。34/43 (79%) 使用 AI 作为独立工具,而 9/43 (21%) 使用 AI 辅助阅读器。23/43 (53%) 使用深度学习。大多数研究存在较高的偏倚风险和适用性问题,限制了结论。独立 AI 荟萃分析中的六项研究得出(汇总)91.2%(95% CI 82.2% 至 95.8%)的灵敏度;16.5%(95% CI 9.4% 至 27.1%)的假阳性率(1-特异性);0.936 ROC-AUC。五项阅读辅助 AI 研究得出(汇总)90.3%(95% CI 88.0% – 92.2%)的灵敏度;7.9%(95% CI 3.5% 至 16.8%)的假阳性率;0.910 ROC-AUC。结论 AI 有潜力帮助临床医生检测脑动脉瘤。由于存在较高的偏倚风险且普遍性较差,因此解释受到限制。需要进行多中心、前瞻性研究来评估临床实践中的人工智能。
Cardiovascular System Cardiomyopathy: Dilated, Hypertrophic, Restrictive, Stress Conduction disorders/dysrhythmias: Atrial fibrillation, Atrial flutter, Atrial tachycardia, Atrioventricular block, Bradycardia, Bundle branch block, Idioventricular rhythm, Junctional, Premature contractions, QT prolongation, Sick sinus syndrome, Sinus arrhythmia, Torsades de pointes, Ventricular fibrillation, Ventricular tachycardia Congenital heart disease: Atrial septal defect, Coarctation of the aorta, Patent ductus arteriosus, Tetralogy of Fallot, Transposition of the great vessels, Ventricular septal defect Coronary artery disease: Acute myocardial infarction, Angina pectoris, Non–ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction, Unstable angina, Atherosclerosis Heart failure Hypertension: Primary hypertension, Secondary hypertension, Hypertensive emergencies, Hypotension: Orthostatic hypotension, Vasovagal hypotension Lipid disorder Shock: Cardiogenic, Distributive, Hypovolemic, Obstructive Traumatic, infectious, and inflammatory heart conditions: Cardiac tamponade, Infective endocarditis, Myocarditis, Pericardial effusion, Pericarditis Valvular disorders: Aortic, Mitral, Pulmonary, Tricuspid Vascular disease: Aortic aneurysm/dissection, Arterial embolism/thrombosis, Arteriovenous malformation, Deep vein thrombosis, Giant cell arteritis, Peripheral artery疾病,静脉炎/血栓性静脉曲张,静脉曲张,静脉功能不全
大血管血管炎(LVV)是涉及主动脉和主要分支的血管炎,包括两种主要亚型,巨细胞动脉炎(GCA)和Takayasu的动脉炎(TAK)[1]。慢性炎症激活可能会导致涉及动脉的进行性血管病理和形态学变化,包括狭窄,闭塞,扩张,动脉瘤形成和破裂,导致相应的器官损伤,严重的并发症,甚至死亡[2,3]。到目前为止,糖皮质激素仍然是GCA和TAK [1]的第一道治疗方法。但是,糖皮质激素的累积或大剂量使用不可避免地会对患者产生不利影响。 同时,许多LVV患者在葡萄糖Coid逐步逐渐缩小过程中遇到疾病复发[4,5]。 ,可以有助于减少糖皮质激素治疗LVV患者的剂量,并在糖皮质激素衰减期间保持疾病控制。但是,糖皮质激素的累积或大剂量使用不可避免地会对患者产生不利影响。同时,许多LVV患者在葡萄糖Coid逐步逐渐缩小过程中遇到疾病复发[4,5]。,可以有助于减少糖皮质激素治疗LVV患者的剂量,并在糖皮质激素衰减期间保持疾病控制。,可以有助于减少糖皮质激素治疗LVV患者的剂量,并在糖皮质激素衰减期间保持疾病控制。
口头摘要 1 血凝块负荷可将中脑周围蛛网膜下腔出血与动脉瘤病因区分开来 Daniel Mandel、Scott Moody、Kelly Pan、Bradford B. Thompson、Linda C. Wendell、Michael E. Reznik、Karen L. Furie、Ali Mahta 布朗大学,罗德岛州普罗维登斯,美国 背景与目的 中脑周围蛛网膜下腔出血 (PMSAH) 是一种以良性为主的蛛网膜下腔出血。然而,在少数 PMSAH 中,后循环动脉瘤是病因。由于担心遗漏动脉瘤,许多机构都追求详尽的影像学检查。我们旨在设计一个预测模型,该模型基于入院时非造影头部计算机断层扫描 (NCHCT) 的放射学特征,以将 PMSAH 与动脉瘤病因区分开来。方法我们回顾性分析了因疑似动脉瘤性 SAH (aSAH) 而入院的学术中心的连续患者。最终诊断为 PMSAH 或后循环 aSAH 的患者被纳入其中。使用 NCHCT,比较了各组基底池和侧裂中血液的厚度(连续变量)和位置(分类变量)。使用具有统计学意义的特征,我们创建了一个评分系统。使用接收者操作特性 (ROC) 来测量该模型预测动脉瘤病因的准确性。结果在 420 例 SAH 病例中,我们发现 56 例患有 PMSAH,48 例患有后循环 aSAH。平均年龄为 54.7 岁(标准差 12.6),58 名患者(54%)为女性。股池和周围池、半球间裂和侧裂的血液厚度测量值以及向侧裂的延伸程度均具有统计学意义(分别为 p=0.001、<0.001、<0.001、<0.001 和 <0.001)。利用这些显著数字,我们开发了一个 10 分制评分模型,以高精度预测动脉瘤病因(曲线下面积 [AUC] 0.98;95% CI 0.96-1.00;每增加一分的优势比:7.6;95% CI 2.6-22)。结论如果经过外部验证,我们的预测模型可能有助于临床医生对 PMSAH 患者进行风险分层。该模型可以最大限度地减少重症监护病房的长期入院时间,并降低医疗资源利用率和成本。
Cardiovascular System Cardiomyopathy: Dilated, Hypertrophic, Restrictive, Stress Conduction disorders/dysrhythmias: Atrial fibrillation, Atrial flutter, Atrial tachycardia, Atrioventricular block, Bradycardia, Bundle branch block, Idioventricular rhythm, Junctional, Premature contractions, QT prolongation, Sick sinus syndrome, Sinus arrhythmia, Torsades de pointes, Ventricular fibrillation, Ventricular tachycardia Congenital heart disease: Atrial septal defect, Coarctation of the aorta, Patent ductus arteriosus, Tetralogy of Fallot, Transposition of the great vessels, Ventricular septal defect Coronary artery disease: Acute myocardial infarction, Angina pectoris, Non–ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction, Unstable angina, Atherosclerosis Heart failure Hypertension: Primary hypertension, Secondary hypertension, Hypertensive emergencies, Hypotension: Orthostatic hypotension, Vasovagal hypotension Lipid disorder Shock: Cardiogenic, Distributive, Hypovolemic, Obstructive Traumatic, infectious, and inflammatory heart conditions: Cardiac tamponade, Infective endocarditis, Myocarditis, Pericardial effusion, Pericarditis Valvular disorders: Aortic, Mitral, Pulmonary, Tricuspid Vascular disease: Aortic aneurysm/dissection, Arterial embolism/thrombosis, Arteriovenous malformation, Deep vein thrombosis, Giant cell arteritis, Peripheral artery疾病,静脉炎/血栓性静脉曲张,静脉曲张,静脉功能不全
AAA Abdominal aortic aneurysm BCI Behavioural and Cultural Insights COSI Childhood Obesity Surveillance Initiative CRC Colorectal cancer CVD Cardiovascular disease EC European Commission EEA European Environment Agency EHIS European Health Interview Survey END Environmental Noise Directive ESPAD European School Survey Project on Alcohol and Other Drugs FCTC Framework Convention on Tobacco Control FIT Faecal immunochemical test EU European Union HBSC Health Behaviour in School-aged Children HEPA Health Enhancing Physical Activity HPV Human papillomavirus IMC Inter-Ministerial Committee LGBTIQ+ Lesbian, Gay, Bisexual, Trans, Intersex and Queer and all other gender and sexual orientations MI Motivational Interviewing NAO National Audit Office NCD Non-communicable diseases NCD GMF Non-communicable diseases global monitoring framework非政府组织非政府组织NHSS NHSS国家卫生系统战略OECD经济学合作与开发组织组织公共卫生筛查和简短干预可持续发展的可持续发展目标SILC的收入和生活条件的统计数据SSB Sugar Sugar Sugar Sugar Sugar Sugar Schoop offenated Uniates Unational wha World World Health Bluse Who World World Health Blose
Cardiovascular System Cardiomyopathy: Dilated, Hypertrophic, Restrictive, Stress Conduction disorders/dysrhythmias: Atrial fibrillation, Atrial flutter, Atrial tachycardia, Atrioventricular block, Bradycardia, Bundle branch block, Idioventricular rhythm, Junctional, Premature contractions, QT prolongation, Sick sinus syndrome, Sinus arrhythmia, Torsades de pointes, Ventricular fibrillation, Ventricular tachycardia Congenital heart disease: Atrial septal defect, Coarctation of aorta, Patent ductus arteriosus, Tetralogy of Fallot, Transposition of the great vessels, Ventricular septal defect Coronary artery disease: Acute myocardial infarction, Angina pectoris, Non–ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction, Unstable angina, Atherosclerosis Heart failure Hypertension: Primary hypertension, Secondary hypertension, Hypertensive emergencies, Hypotension: Orthostatic hypotension, Vasovagal hypotension Lipid disorder Shock: Cardiogenic, Distributive, Hypovolemic, Obstructive Traumatic, infectious, and inflammatory heart conditions: Cardiac tamponade, Infective endocarditis, Myocarditis, Pericardial effusion, Pericarditis Valvular disorders: Aortic, Mitral, Pulmonary, Tricuspid Vascular disease: Aortic aneurysm/dissection, Arterial embolism/thrombosis, Arteriovenous malformation, Deep vein thrombosis, Giant cell arteritis, Peripheral artery疾病,静脉炎/血栓性静脉曲张,静脉曲张,静脉功能不全