Influencing factors of the outcome after endovascular treatment in patients with large vessel occlusive stroke in anterior circulation
10.3760/cma.j.issn.1673-4165.2024.10.003
- VernacularTitle:前循环大血管闭塞性卒中患者血管内治疗后转归的影响因素
- Author:
Hongfu TIAN
1
;
Hong XIA
;
Jiachen GU
;
Liangxian LIU
;
Weixia YANG
;
Mingyuan LIU
Author Information
1. 复旦大学附属中山医院青浦分院神经内科，上海 201700
- Keywords:
Ischemic stroke;
Endovascular procedures;
Thrombectomy;
Cerebral infarction;
Perfusion imaging;
Tomography, X-ray computed;
Treatment outcome
- From:
International Journal of Cerebrovascular Diseases
2024;32(10):735-740
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influencing factors of the outcome after endovascular therapy (EVT) in patients with large vessel occlusive stroke in anterior circulation.Methods:Patients with large vessel occlusive stroke in anterior circulation received EVT at the Qingpu Branch of Zhongshan Hospital Affiliated with Fudan University and the Fourth Affiliated Hospital of Nanjing Medical University from October 2022 to December 2023 were included retrospectively. The modified Rankin Scale was used for outcome evaluation at 90 days after onset, ≤2 points were defined as good outcome and >2 points were defined as poor outcome. Multivariate logistic regression analysis was used to identify independent influencing factors for poor outcome after EVT. Results:A total of 156 patients with large vessel occlusive stroke in anterior circulation received EVT were enrolled from two stroke centers, including 81 males (51.9%), aged 73.32±9.68 years. Sixty-nine patients (44.2%) had good outcome, 87 (55.8%) had poor outcome. Univariate analysis showed that there were significant differences in the onset-to-door time, door-to-puncture time, puncture-to-reperfusion time, baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline Alberta Stroke Program Early CT Score (ASPECTS), core infarct volume, ischemic penumbra volume, modified Thrombolysis in Cerebral Infarction (mTICI), postprocedural intracranial hemorrhage, and symptomatic intracranial hemorrhage between the good outcome group and the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that the baseline NIHSS score (odds ratio [ OR] 1.107, 95% confidence interval [ CI] 1.010-1.213; P=0.029), door-to-puncture time ( OR 1.014, 95% CI 1.000-1.028; P=0.048), onset-to-door time ( OR 1.006, 95% CI 1.003-1.009; P<0.001), the core infarct volume ( OR 1.043, 95% CI 1.004-1.084; P=0.029), and mTICI <2b ( OR 10.117, 95% CI 1.896-53.983; P=0.007) were the independent risk factors for poor outcome, while baseline ASPECTS ( OR 0.976, 95% CI 0.961-0.991; P=0.002) and ischemic penumbra volume ( OR 0.359, 95% CI 0.203-0.634; P<0.001) were the independent protective factors for good outcome. Conclusion:For patients with large vessel occlusive stroke in anterior circulation, higher baseline NIHSS score, longer onset-to-door time and door-to-puncture time, larger core infarct volume, and mTICI <2b are associated with the poor outcome after EVT, while higher baseline ASPECTS and larger ischemic penumbra volume are associated with the good outcome.
