Predictors of early neurological deterioration after endovascular therapy in patients with large vessel occlusive stroke in anterior circulation
10.3760/cma.j.issn.1673-4165.2024.09.002
- VernacularTitle:前循环大血管闭塞性卒中患者血管内治疗后早期神经功能恶化的预测因素
- Author:
Qing ZHOU
1
;
Xiaoge ZHANG
;
Yang GAO
;
Meng ZUO
Author Information
1. 陆军军医大学第一附属医院神经内科，重庆 400038
- Keywords:
Ischemic stroke;
Endovascular procedures;
Thrombectomy;
Disease progression;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2024;32(9):648-653
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictors of early neurological deterioration (END) after endovascular therapy (EVT) in patients with large vessel occlusive stroke in anterior circulation.Methods:Patients with acute large vessel occlusive stroke in anterior circulation received EVT at Southwest Hospital and Zigong Third People's Hospital from January 2017 to April 2021 were included retrospectively. The patients were divided into END group and non-END group based on whether END occurred after EVT. The demographic and clinical data of the two groups were compared. Multivariate logistic regression analysis was used to determine the independent correlation factors of END after EVT. Results:A total of 359 patients were enrolled, including 191 males (53.2%), aged 69.30±12.07 years, and 73 patients (20.3%) had END. Univariate analysis showed that neutrophil count, the proportion of patients with any intracranial hemorrhage, symptomatic intracranial hemorrhage (sICH), and poor collateral circulation in the END group was significantly higher than that in the non-END group, but diastolic blood pressure and the proportion of patients with successful recanalization was significantly lower than that in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that good collateral circulation (odds ratio [ OR] 0.538, 95% confidence interval [ CI] 0.306-0.945; P=0.031) and successful recanalization ( OR 0.244, 95% CI 0.095-0.629; P=0.003) were the independent protective factors of END after EVT, while sICH was an independent risk factor for END after EVT ( OR 3.884, 95% CI 1.426-10.579; P=0.008). Conclusions:Patients with acute large vessel occlusive stroke in anterior circulation with poor collateral circulation, sICH, and unsuccessful recanalization are more likely to have END after EVT. Attention should be paid to the above risk factors and effective measures should be taken timely to prevent the occurrence of END.
