Study on the Correlation between the Severity of Leukoaraiosis and the Prognosis of Acute Ischemic Stroke with Large Vessel Occlusion treated with Mechanical Thrombectomy
- VernacularTitle:脑白质疏松严重程度与急性大血管闭塞性脑卒中机械取栓治疗预后的相关性研究
- Author:
Yong XI
1
;
Chunye MA
1
;
Dapeng SUN
1
Author Information
- Publication Type:Journal Article
- Keywords: Acute Ischemic Stroke; Leukoaraiosis; Mechanical Thrombectomy; Prognosis
- From: Journal of Apoplexy and Nervous Diseases 2022;39(9):794-798
- CountryChina
- Language:Chinese
- Abstract: To explore whether the severity of LA in patients with acute ischemic stroke（AIS）with large vessel occlusion（AIS-LVO） was related to the prognosis of MT treatment. Methods A total of 75 AIS-LVO patients who received intravenous thrombolysis（IVT） bridging MT or MT alone were selected in the stroke center of our hospital from April 2016 to October 2021.According to the Fazekas score scale，the severity of LA was divided into non-mild group（0-2 points，n=44） and moderate-severe group（3～6 points，n=31）. The baseline data and postoperative outcome of MT were compared between the two groups. The prognosis at 90 days after operation was evaluated by modified Rankin scale（mRS）. The results were divided into two groups：good prognosis group（0～2 points，n=32） and poor prognosis group（3～6 points，n=43）. Univariate analysis and multivariate Logistic regression analysis were used to determine whether LA was related to the prognosis of at 90 days after MT.Results Univariate analysis showed that compared with the non-mild LA group，the moderate-severe LA group had an older age［（73.77±8.25） vs（63.00±10.50） years old］，higher female proportion（58.1% vs 22.7%），higher proportion of atrial fibrillation（61.3% vs 36.4%），lower proportion of hyperlipidemia（9.7% vs 29.5%），higher incidence of postoperative hemorrhage transformation（38.7% vs 13.6%），higher incidence of sICH at 72 hours after operation（19.4% vs 2%），higher rate of futile recanalization（78.6% vs 39.0%），and higher incidence of 90-day poor prognosis after operation（80.6% vs 40.9%）. There were significant differences between two groups（all P<0.05）. Univariate analysis showed that compared with the good prognosis group，the poor prognosis group had an older age［69.0（63.0，77.0）vs 63.5（53.0，75.5）years old］，higher baseline NIHSS score ［（17.8±6.8） vs（12.3±4.9） points］，higher fasting blood glucose level［6.78（5.71，10.43） vs 5.88（5.29，6.95）］ mmol/L］，higher neutrophil to lymphocyte ratio（NLR） ［4.48（1.92，8.11） vs 2.4（1.43，3.06）］，higher proportion of diabetes（37.2% vs 12.5%），and higher proportion of moderate-severe LA（58.1% vs 18.8%）. There were significant difference between two groups（all P<0.05）.Multivariate Logistic regressionanalysis showed that moderate-severe LA（OR=6.796，95%CI 1.564～29.530，P=0.011）and baseline NIHSS score（OR=1.156，95%CI 1.015～1.317，P=0.029） were independent risk factors for poor 90-day functional prognosis after MT.Conclusion Moderate-severe LA can independently predict the poor prognosis of patients with AIS-LVO after MT.
- Full text:2024072321585964311Study on the Correlation between the Severity of Leukoaraiosis and the Prognosis of Acute Ischemic Stroke with Large Vessel Occlusion treated with Mechanical Thrombectomy.pdf
