Influencing factors of futile recanalization after endovascular intervention in patients with acute basilar artery occlusion
10.3724/zdxbyxb-2023-0425
- VernacularTitle:急性基底动脉闭塞患者血管内治疗后发生无效再通的影响因素
- Author:
Yi YAN
1
,
2
;
Kemeng ZHANG
;
Wansi ZHONG
;
Shenqiang YAN
;
Bing ZHANG
;
Jianhua CHENG
;
Min LOU
Author Information
1. 浙江大学医学院附属第二医院神经内科,浙江 杭州 310009
2. 镇海区人民医院神经内科,浙江 宁波 315202
- Keywords:
Acute ischemic stroke;
Basilar artery;
Endovascular treatment;
Recanalization;
Retrospetive study
- From:
Journal of Zhejiang University. Medical sciences
2024;53(2):141-150
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influence factors for futile recanalization following endovascular treatment(EVT)in patients with acute basilar artery occlusion(BAO).Methods:Clinical data of patients with acute BAO,who underwent endovascular treatment within 24 h of onset from January 2017 to November 2022,were retrospectively analyzed.The futile recanalization was defined as modified thrombolysis in cerebral infarction(mTICI)grade≥2b or 3 after successful reperfusion,but the modified Rankin Scale score>2 at 3 months after EVT.Binary logistic regression model was used to analyze the influencing factors of futile recanalization.Results:A total of 471 patients with a median age of 68(57,74)years were included and 68.9%were males,among whom 298(63.27%)experienced futile recanalization.Multivariate analysis revealed that concomitant atrial fibrillation(OR=0.456,95%CI:0.282-0.737,P<0.01),bridging thrombolysis(OR= 0.640,95%CI:0.416-0.985,P<0.05),achieving mTICI grade 3(OR=0.554,95%CI:0.334-0.918,P<0.05),arterial occlusive lesion(AOL)grade 3(OR=0.521,95%CI:0.326-0.834,P<0.01),and early postoperative statin therapy(OR=0.509,95%CI:0.273-0.948,P<0.05)were protective factors for futile recanalization after EVT in acute BAO patients.High baseline National Institutes of Health Stroke Scale(NIHSS)score(OR=1.068,95%CI:1.049-1.087,P<0.01),coexisting hypertension(OR=1.571,95%CI:1.017-2.427,P<0.05),multiple retrieval attempts(OR=1.237,95%CI:1.029-1.488,P<0.05)and postoperative hemorrhagic transformation(OR=8.497,95%CI:2.879-25.076,P<0.01)were risk factors.For trial of ORG 10172 in acute stroke treatment(TOAST)classification,cardiogenic embolism(OR=0.321,95%CI:0.193-0.534,P<0.01)and other types(OR=0.499,95%CI:0.260-0.961,P<0.05)were related to lower incidence of futile recanalization.Conclusions:The incidence of futile recanalization after EVT in patients with acute BAO is high.Bridging venous thrombolysis before operation and an early postoperative statin therapy may reduce the incidence of futile recanalization.
