Clinical prognoses of acute ischemic stroke patients with large core infarction after endovascular therapy and their influencing factors
10.3760/cma.j.cn115354-20210326-00197
- VernacularTitle:伴大面积核心梗死的急性缺血性脑卒中血管内治疗的预后及其影响因素分析
- Author:
Ji LIU
1
;
Feng HE
;
Xianjun WANG
;
Meng'en WANG
;
Tongtong ZHANG
;
Xin HUI
;
Lijun ZHANG
;
Wang CHEN
;
Hongyang SUN
Author Information
1. 临沂市人民医院（青岛大学第十一临床学院）神经内科 276000
- Keywords:
Large area core infarction;
Acute ischemic stroke;
Endovascular therapy;
Prognosis;
Influencing factor
- From:
Chinese Journal of Neuromedicine
2021;20(8):805-811
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical prognoses of acute ischemic stroke (AIS) patients with large core infarction after endovascular therapy (EVT) and their influencing factors.Methods:Totally, 139 AIS patients with large area core infarction (volume of infarction core area≥70 mm3) admitted to our hospital from November 2019 to December 2020 were enrolled in our study; their clinical data were analyz ed retrospectively. These patients were divided into EVT group ( n=78) and non-EVT group ( n=61) according to whether endovascular treatment was performed, and the clinical prognoses of patients from the 2 groups were compared. According to the 3-month modified Rankin scale (mRS) scores, the patients in the EVT group were divided into good prognosis subgroup (mRS scores≤2) and poor prognosis subgroup (mRS scores>2); univariate and multivariate Logistic regressions were used to analyze the independent influencing factors for prognoses of AIS patients with large area core infarction after EVT. Results:As compared with those in the non-EVT group, patients in the EVT group had significantly higher good prognosis rate (11.48% vs. 42.31%), and significantly lower proportion of patients with neurological deterioration, cerebral hernia and death ( P<0.05). As compared with the poor prognosis subgroup, the good prognosis subgroup had significantly lower percentage of patients with atrial fibrillation, significantly higher percentage of conscious patients, significantly higher Alberta stroke program early CT scale (ASPECT) scores, statistically lower volume of infarction core areas, and significantly higher percentage of patients with grading 2-4 in collateral circulation ( P<0.05). ASPECT scores ( OR=4.164, 95%CI: 2.081-8.332, P=0.000), volume of infarction core areas ( OR=0.917, 95%CI: 0.855-0.984, P=0.016), and collateral circulation grading ( OR=5.113, 95%CI: 1.104-23.683, P=0.037) were independent influencing factors for prognoses of AIS patients with large area core infarction after EVT. Conclusion:EVT can effectively improve the prognoses and reduce the complication rate of AIS patients with large area core infarction; patients with high ASPECT scores, low infarct core volume, and high collateral circulation grading get great benefits.
