Classifications of acute distal occlusion of internal carotid artery and variation of Willis' circle in predicting prognoses of acute ischemic stroke patients after mechanical thrombectomy
10.3760/cma.j.cn115354-20220223-00095
- VernacularTitle:急性颈内动脉末端闭塞分型及Willis环变异在机械取栓治疗预后判断中的应用
- Author:
Wenjuan WU
1
;
Yue CHENG
;
Jingxuan JIANG
;
Dongmei CAI
;
Lei ZHANG
Author Information
1. 无锡市第二人民医院影像科，无锡 214002
- Keywords:
Distal occlusion of internal carotid artery;
Willis' circle;
Mechanical thrombectomy;
CT angiography
- From:
Chinese Journal of Neuromedicine
2022;21(5):450-455
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application values of classifications of acute distal occlusion of internal carotid artery and variation of Willis' circle in predicting prognoses of acute ischemic stroke patients after mechanical thrombectomy (MT).Methods:One hundred and fifty-eight patients with acute ischemic stroke, admitted to our hospital from January 2016 to November 2020, were chosen in our study; these patients had conformed imaging diagnosis of acute distal occlusion of internal carotid artery and accepted endovascular MT; the clinical and imaging data of these patients were retrospectively analyzed. The distal occlusion of internal carotid artery was divided into Ia, Ib, L, and T types according to the occlusion positions. Prognoses were evaluated by modified Rankin Scale (mRS) 90 d after treatment. Multivariate Logistic regression was used to determine the independent factors for prognoses.Results:Among these 158 patients, 58 patients achieved good prognosis and 100 had poor prognosis. As compared with patients in the poor prognosis group, patients in the good prognosis group had significantly younger age, significantly lower NIHSS scores at admission, and statistically lower atrial fibrillation ratio ( P<0.05). There were statistical differences in the classifications of acute distal occlusion of internal carotid artery between the two groups ( P<0.05): the proportion of Ia type in patients of good prognosis group was the highest (75.9%), while that of T type was the lowest (3.4%). There was no significant difference in variation of Willis' circle between the two groups ( P>0.05). Multivariate Logistic regression analysis showed that T type of acute distal occlusion of internal carotid artery and atrial fibrillation were independent factors for prognoses of these patients ( OR=0.342, 95%CI: 0.127-0.919, P=0.033; OR=0.066, 95%CI: 0.005-0.803, P=0.033). Conclusion:Patients with T type of acute distal occlusion of internal carotid artery and atrial fibrillation are trend to have poor prognosis.
