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Association of antithrombotic therapy with postoperative rebleeding in patients with cerebral amyloid angiopathy

Chinese Neurosurgical Journal 2023年第3期9卷 159-165页

作者： Taro Yanagawa Hiroki Sato Kaima Suzuki hidetoshi ooigawa Masaki Takao Hiroki Kurita Department of Cerebrovascular Surgery International Medical CenterSaitama Medical University1397-1 YamaneHidaka CitySaitama 350-1298Japan Stroke Center Sagamihara Kyodo Hospital4-3-1 HashimotodaiMidori-KuSagamihara CityKanagawa-Pref 252-5188Japan Department of Clinical Laboratory National Center of Neurology and PsychiatryNational Center Hospital4-1-1Ogawa-HigashiKodairaTokyo 187-8502Japan

Background Cerebral amyloid angiopathy is a common cause of subcortical hemorrhage in older *** open hematoma removal may be performed for severe subcortical hemorrhage,its safety in patients with cerebral amyloid angiopathy has not been established,and postoperative rebleeding may ***,this study aimed to investigate factors associated with postoperative *** Out of 145 consecutive patients who had undergone craniotomy for surgical removal of subcortical intracerebral hemorrhage between April 2010 and August 2019 at a single institution in Japan,we examined 109 patients with subcortical hemorrhage who met the inclusion *** excluding 30 patients whose tissue samples were unsuitable for the study,the final study cohort comprised 79 *** Of the 79 patients,50(63%)were diagnosed with cerebral amyloid angiopathy(cerebral amyloid angiopathy group)and 29(37%)were not diagnosed with noncerebral amyloid angiopathy(noncerebral amyloid angiopathy group).Postoperative rebleeding occurred in 12 patients(24%)in the cerebral amyloid angiopathy group and in 2 patients(7%)in the noncerebral amyloid angiopathy *** prothrombin time-international normalized ratio and intraoperative bleeding volume were significantly associated with postoperative rebleeding in the cerebral amyloid angiopathy group(odds ratio=42.4,95%confidence interval=1.14-1578;p=0.042 and odds ratio=1.005,95%confidence interval=1.001-1.008;p=0.007,respectively).Conclusions Patients with cerebral amyloid angiopathy-related cerebral hemorrhage who are receiving antithrombotic therapy,particularly warfarin therapy,are at a high risk of postoperative *** registration Registry and Registration Number of the study:19-220,2019/12/23,retrospectively registered.

关键词： Amyloid-β Antithrombotic therapy Cerebral amyloid angiopathy Postoperative rebleeding Subcortical hemorrhage

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