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Recomendaciones para el diagnóstico y manejo del ACV isquémico agudo en el Hospital Universitario Nacional de Colombia
dc.rights.license | Atribución-NoComercial-SinDerivadas 4.0 Internacional |
dc.contributor.advisor | Neira, Fabian Enrique |
dc.contributor.advisor | Pardo, Rodrigo |
dc.contributor.author | Castañeda Castillo, Luisa María |
dc.contributor.author | Rosales Manjarrez, José Santander |
dc.date.accessioned | 2021-02-04T14:39:29Z |
dc.date.available | 2021-02-04T14:39:29Z |
dc.date.issued | 2020-10-20 |
dc.identifier.citation | Castañeda Castillo, L. M. & Rosales Manjarrez, J. S. (2020). Recomendaciones para el diagnóstico y manejo del ACV isquémico agudo en el Hospital Universitario Nacional de Colombia [Tesis de especialidad, Universidad Nacional de Colombia]. Repositorio Institucional. |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/79070 |
dc.description.abstract | Proponemos recomendaciones de diagnóstico y manejo del accidente cerebrovascular isquémico para el Hospital Universitario Nacional de Colombia basados en la mejor evidencia disponible, destacando la importancia de la organización, especificación del rol de cada actor y el control del tiempo, con el objetivo de brindar a nuestros pacientes la mejor calidad, oportunidad y eficiencia en su atención. Se propone implementar recomendaciones basadas en las Guías del Ministerio de Salud de 2015, del Royal College of Physicians de Londres y de la American Heart/Stroke Association del 2019 evaluadas por los autores de alta calidad según la calificación AGREE II. Adicionalmente, para complementar y actualizar algunas de estas recomendaciones en temas críticos preestablecidos, realizamos una búsqueda sistemática de la literatura en diferentes bases de datos, bajo la modalidad resumen de revisiones sistemáticas, obteniendo 16 artículos de alta calidad evaluados mediante la herramienta ROBIS, de los cuales se generaron recomendaciones condicionales (sujetas a constante actualización) en las que se apoya el uso de terapia endovascular en ventana ampliada (24 horas), la realización de trombectomía mecánica con o sin terapia puente (trombolisis IV) y así mismo, aunque la calidad de la evidencia en el ACV de fosa posterior es baja, se propone brindarle a estos pacientes manejo endovascular, siempre que sea prudente y esté indicado. En cuanto a los dispositivos y técnicas de trombectomía mecánica, la evidencia favorece el uso de Stent Retrievers de segunda generación, sin embargo, existe la posibilidad que técnicas como ADAPT puedan brindar eficiencia y seguridad en el manejo de esta patología. |
dc.description.abstract | We propose recommendations for the diagnosis and management of ischemic stroke for the National University Hospital of Colombia based on the best available evidence, highlighting the importance of organization, specifying the role of each actor and time management, with the aim of providing our patients the best quality, opportunity and efficiency in their care. It is proposed to implement recommendations based on the Guides of the Ministry of Health of 2015, the Royal College of Physicians of London and the American Heart / Stroke Association of 2019 evaluated by the high-quality authors according to the AGREE II rating. In addition, to complement and update some of these recommendations on pre-established critical issues, we conducted a systematic search of the literature in different databases, under the summary modality of systematic reviews, obtaining 16 high-quality articles evaluated using the ROBIS tool, of which conditional recommendations were generated (subject to constant updating) that support the use of endovascular therapy in an extended window (24 hours), the performance of mechanical thrombectomy with or without bridging therapy (IV thrombolysis) and likewise, although the quality of the evidence in posterior fossa stroke is low, it is proposed to provide these patients with endovascular management, provided it is prudent and indicated. Regarding mechanical thrombectomy devices and techniques, the evidence favors the use of second-generation Stent Retrievers, however, there is the possibility that techniques such as ADAPT can provide efficiency and safety in the management of this pathology. |
dc.format.extent | 151 |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.rights | Derechos reservados - Universidad Nacional de Colombia |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.subject.ddc | 610 - Medicina y salud |
dc.title | Recomendaciones para el diagnóstico y manejo del ACV isquémico agudo en el Hospital Universitario Nacional de Colombia |
dc.type | Otro |
dc.rights.spa | Acceso abierto |
dc.description.additional | Trabajo de investigación presentado como requisito parcial para optar al título de Especialista en Neurología Clínica de José Santander Rosales Manjarrez. |
dc.type.driver | info:eu-repo/semantics/other |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Especialidad en Radiología e Imágenes Diagnósticas |
dc.publisher.program | Bogotá - Medicina - Especialidad en Neurología Clínica |
dc.description.degreelevel | Especialidades Médicas |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
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dc.rights.accessrights | info:eu-repo/semantics/openAccess |
dc.subject.proposal | Accidente cerebrovascular isquémico |
dc.subject.proposal | Stroke |
dc.subject.proposal | Endovascular treatment |
dc.subject.proposal | Manejo endovascular |
dc.subject.proposal | Mechanical thrombectomy |
dc.subject.proposal | Trombectomía mecánica |
dc.subject.proposal | Trombolisis intravenosa |
dc.subject.proposal | Intravenous thrombolysis |
dc.subject.proposal | Terapia puente |
dc.subject.proposal | Bridging therapy |
dc.type.coar | http://purl.org/coar/resource_type/c_1843 |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | Text |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
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