Analysis of relevant factors affecting the prognosis of mechanical thrombectomy in patients with acute posterior circulation large vessel occlusion cerebral infarction
Xiaofeng Qu, Yaying Xu, Liling Wang, Taojie Ren, Yang Gao
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引用次数: 0
Abstract
Objective
To explore the factors affecting the prognosis of patients with acute posterior circulation large vessel occlusion cerebral infarction (PCO) after mechanical thrombectomy.
Method
A retrospective study was conducted on a total of 58 patients who received thrombectomy and presented within 24 h of onset with PCO from 31 September 2020 to 31 December 2022. They were divided into two groups based on a 90-day mRS score(The mRS score of 0–3 was defined as a good prognosis, and 4–6 was defined as a poor prognosis).A univariate analysis was conducted on baseline data such as age and patient past medical history, as well as extended cerebral infarction thrombolysis grade (eTICI grade) and incidence of symptomatic intracranial hemorrhage (sICH) after surgery, for the groups with good prognosis and poor prognosis. Factors affecting the 90-day prognosis of patients were also analyzed in subgroups.
Results
The preoperative National Institutes of Health Stroke Scale (NIHSS score)[21(12–35) vs 35(35–35)], postoperative 24-h NIHSS score[13(8–22) vs 35(35–35)], computed tomography (CT)[9(9–10) vs 6.5(6–7.75)] and computed tomography (CTP) brain blood volume (CBV)[9(8–10) vs 4(2–7.75)], cerebral blood flow (CBF)[7(4.5–9) vs 2(1–4)], time to peak (Tmax) [1(0.5–4) vs 0(0–1.75)] imaging of the posterior circulation Alberta stroke project early CT score (pc-ASPECTS score), Different locations of vascular occlusion, time from femoral artery puncture to vascular recanalization(64.96 ± 33.47 vs 92.68 ± 53.17). The differences in the conversion rate of postoperative intracranial hemorrhage(0 vs 16.1%) and the incidence of sICH(0 vs 12.9%) were statistically significant (P < 0.05). The subgroup analysis showed that vascular occlusion site, preoperative CBV pc-ASPECTS scores, and postoperative sICH occurrence were related to the 90-day prognosis of patients, and the differences were statistically significant (P < 0.05).
Conclusions
Some factors that can affect the prognosis of mechanical thrombectomy in patients with acute posterior circulation large vessel occlusion cerebral infarction. Preoperative clinical symptoms and imaging evaluation have certain evaluation values for prognosis.
目的 探讨影响急性后循环大血管闭塞性脑梗死(PCO)患者机械取栓术后预后的因素。方法 对2020年9月31日至2022年12月31日期间接受取栓术并在发病24 h内出现PCO的58例患者进行回顾性研究。对预后良好组和预后不良组的基线数据(如年龄、既往病史)、扩展脑梗死溶栓分级(eTICI分级)和术后症状性颅内出血(sICH)发生率进行单变量分析。结果术前美国国立卫生研究院卒中量表(NIHSS)评分[21(12-35) vs 35(35-35)]、术后 24 h NIHSS 评分[13(8-22) vs 35(35-35)]、计算机断层扫描(CT)[9(9-10) vs 6.5(6-7.75)]和计算机断层扫描(CTP)脑血容量(CBV)[9(8-10) vs 4(2-7.75)]、脑血流量(CBF)[7(4.5-9) vs 2(1-4)]、达峰时间(Tmax)[1(0.5-4) vs 0(0-1.75)]后循环阿尔伯塔卒中项目早期 CT 评分(pc-ASPECTS 评分)成像、血管闭塞的不同位置、从股动脉穿刺到血管再通的时间(64.96 ± 33.47 vs 92.68 ± 53.17)。术后颅内出血转归率(0 vs 16.1%)和sICH发生率(0 vs 12.9%)差异有统计学意义(P < 0.05)。亚组分析显示,血管闭塞部位、术前CBV pc-ASPECTS评分、术后sICH发生率与患者90天预后有关,差异有统计学意义(P <0.05)。术前临床症状和影像学评估对预后有一定的评估价值。
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.