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芝加哥－北美放射学会（RSNA）2006年会议公布的一项研究显示，静脉注射阿司匹林可显著减少患者脑动脉瘤栓塞术的血栓栓塞事件。该研究的作者周四报道，159名使用阿司匹林的动脉瘤患者与102名未使用抗血小板治疗的动脉瘤患者相比，血栓栓塞事件的发生率降低50％。

德国Hamburg-Eppendorf 大学医学中心的神经放射学家Thorsten Ries研究了247名患者261例动脉瘤的介入栓塞治疗。其中2001～2003年间未使用阿司匹林治疗的动脉瘤102例，2003年1月～2004年9月采用静脉注射阿司匹林250mg治疗的动脉瘤159例。

研究者发现，在102例未用阿司匹林的动脉瘤栓塞术中共有18例发生血栓栓塞事件，发生率为17.6％。在使用阿司匹林的159例动脉瘤螺圈栓塞术中共有14例发生血栓栓塞事件，发生率为8.8％。两组血栓栓塞事件的发生率具有统计学差异，p = 0.028。

Ries认为，静脉注射阿司匹林可以降低血栓栓塞事件的发生率，且不增加术中出血的发生率或出血的严重程度。在动脉瘤介入栓塞术中，静脉使用阿司匹林是可行的，也是安全的。

本次会议主席、旧金山加利福尼亚大学放射学副教授Christopher Dowd 博士说：“该研究显示，阿司匹林可将血栓栓塞事件的发生率降低50%，结果是令人震惊的。阿司匹林主要用来预防血液凝固，在用螺圈栓塞动脉瘤时，使用阿司匹林可防止正常血管不应出现的血栓。这就好像开车时一脚踩刹车，一脚踩油门。”

Dowd 认为阿司匹林口服或直肠给药可产生与静脉给药相似的抗血小板作用。目前阿司匹林静脉给药尚未被美国食品与药品管理局（FDA）批准在美国应用。

Intravenous aspirin reduces complications in brain aneurysm embolization
12/1/2006
By: Edward Susman

CHICAGO - Patients who were treated with intravenous acetylsalicylic acid, commonly known as aspirin, had significantly reduced thromboembolic events when doctors attempted to perform embolization of cerebral aneurysms, according to a study presented at the 2006 RSNA meeting.
Thromboembolic event rates were halved among the 159 aneurysms in patients treated with acetylsalicylic acid compared to the 102 aneurysms in patients treated without the antiplatelet agent, the study authors reported on Thursday.

"Intravenous application of acetylsalicylic acid is feasible and safe during interventional aneurysm embolization," said Thorsten Ries, a neuroradiologist at the University Medical Center Hamburg-Eppendorf in Germany.

Ries reported on the treatment of 247 patients who presented with 261 aneurysms that doctors attempted to close using interventional rather than surgical methods. The study included 102 aneurysms treated between 2001 and 2003 without the use of intravenous acetylsalicylic acid. From January 2003 to September 2004, the doctors treated 159 aneurysms with 250 mg of intravenous acetylsalicylic acid included.

The researchers found that thromboembolic events during the procedure occurred in 18 of the 102 aneurysm embolizations attempted without acetylsalicylic acid -- a rate of 17.6%. Among the patients treated with acetylsalicylic acid, 14 thromboembolic events occurred among the 159 aneurysm coil embolization procedures -- a rate of 8.8%. That difference in event rate reached statistical significance at the p = 0.028 level, Ries said in his presentation.

"Intravenous acetylsalicylic acid seems to be associated with a significant reduction in the rate of thromboembolic events without increase in the rate or severity of intraoperative bleeding," he said.

"Intravenous aspirin is not approved by the Food and Drug Administration for use in the United States," said Dr. Christopher Dowd, an associate professor of radiology at the University of California, San Francisco, and the session moderator. "We wish we had it."

"This study showed that aspirin can reduce events by half. That is impressive. It may seem counterintuitive that we would give aspirin, which is designed to prevent clotting, when we want to clot off another blood vessel," he said.

"I liken it to driving with one foot on the brake and one foot on the gas," Dowd said. The idea is to use aspirin to prevent inappropriate clotting, while the embolization coils perform their job in clotting the aneurysm. "We don't want the healthy blood vessels to clot, and we use aspirin to prevent that."

Aspirin administered orally or rectally provides similar antiplatelet protection as the intravenous form of the drug, Dowd said.

By Edward Susman
AuntMinne.com contributing writer

http://www.auntminnie.com/index.asp?Sec=nws&Sub=rad&Pag=dis&ItemId=73840

编辑：蓝色幻想