Comparison of clinical efficacies of endovascular treatments in patients with acute basilar artery occlusion caused by large-artery atherosclerosis and cardioembolism
10.3760/cma.j.cn115354-20220727-00526
- VernacularTitle:大动脉粥样硬化型与心源性栓塞型急性基底动脉闭塞血管内治疗的临床疗效比较
- Author:
Xiaohu PAN
1
;
Fayong ZHU
;
Ya LIU
;
Fasheng WANG
;
Yuezhou CAO
;
Zhenyu JIA
;
Linbo ZHAO
;
Sheng LIU
Author Information
1. 淮安市盱眙县人民医院神经内科，淮安 211700
- Keywords:
Acute basilar artery occlusion;
Cardioembolism;
Large-artery atherosclerosis;
Endovascular treatment
- From:
Chinese Journal of Neuromedicine
2022;21(11):1097-1103
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacies of endovascular treatments in patients with acute basilar artery occlusion (ABAO) caused by large-artery atherosclerosis (LAA) and cardioembolism (CE).Methods:From March 2018 to February 2021, 104 patients with ABAO accepted endovascular treatments in Department of Neurology and Department of Interventional Radiology, Xuyi County People's Hospital of Huaian City were enrolled; these patients were classified into either a LAA group or a CE group according to Trial of ORG 10172 in Acute Stroke Treatment classification (TOAST). The differences in general data, procedure information, and clinical efficacies were compared between the 2 groups. Univariate and multivariate Logistic regression analyses were used to identify the influencing factors for poor prognosis.Results:In these 104 patients, 51 patients (49.0%) were into the LAA group and 53 patients (51.0%) into the CE group. Ninety-six patients (92.3%) acquired successful revascularization, and 35 patients (33.7%) had good prognosis (modified Rankin scale scores of 0-2) 90 d after surgery. LAA group had significantly lower percentage of patients with atrial fibrillation, significantly lower baseline National Institutes of Health Stroke Scale scores, statistically higher percentages of patients with lower and middle basilar artery occlusion and patients accepted rescued stenting, and statistically longer procedure time ( P<0.05). There were no significant differences between the two groups in terms of successful recanalization percentage, symptomatic intracranial hemorrhage incidence, and prognosis 90 d after surgery ( P>0.05). Age ( OR=0.935, 95%CI: 0.891-0.981, P=0.006) and semiquantitative scores of basilar artery based on computed tomography angiography ( OR=1.520, 95%CI: 1.180-1.959, P=0.001) were independent influencing factors for poor prognosis. TOAST etiology (LAA/CE) was not an independent influencing factors for poor prognosis ( OR=1.175, 95%CI: 0.461-2.933, P=0.736). Conclusion:There are differences in risk factors, vascular occlusion sites, endovascular treatment, and procedure time between patients with ABAO caused by LAA and CE; however, no obvious difference in clinical outcomes is noted, and there was no obvious correlation between stroke etiology and prognoses.
