The factors influencing the prognosis of patients with symptomatic severe intracranial artery stenosis after interventional therapy and the construction of nomogram prediction model
10.3969/j.issn.1008-794X.2025.06.013
- VernacularTitle:症状性颅内动脉重度狭窄患者介入治疗预后的影响因素及列线图预测模型构建
- Author:
Jianjiang FAN
1
;
Chaogang WANG
;
Yuanjie XU
;
Xinhui CAO
;
Xiaoman ZHANG
Author Information
1. 450000 河南郑州 新乡医学院附属郑州市第一人民医院神经内科
- Keywords:
symptomatic severe intracranial artery stenosis;
interventional therapy;
prognostic factor;
nomogram prediction model
- From:
Journal of Interventional Radiology
2025;34(6):631-638
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors affecting the prognosis of patients with symptomatic severe intracranial artery stenosis after interventional therapy,and to construct a nomogram prediction model accordingly.Methods The clinical data of 121 patients with symptomatic severe intracranial artery stenosis,who received interventional treatment at the First People's Hospital of Zhengzhou from June 1,2021 to October 31,2024,were retrospectively analyzed.The general data,characteristics of vascular lesions,treatment-related factors and prognosis of patients were collected.According to the modified Rankin scale(mRS)score,the patients were divided into good prognosis group(mRS score ≤2 points)and poor prognosis group(mRS score＞2 points).The clinical data were compared between the two groups.Multivariate logistic regression analysis was used to identify and determine independent factors affecting patient's outcomes,to construct a nomogram prediction model and to validate this model.Results Among the 121 patients,31(25.61％)had poor prognosis and 90(74.38％)had good prognosis.The postoperative 3-month mRS score was lower than preoperative mRS score value(P＞0.05).There were significant differences in hypertension history,stenosis site,stenosis degree,collateral circulation state,interventional therapeutic mode,cholesterol level,platelet count,lesion length and preoperative NIHSS score(P＜0.05)between the poor prognosis group and the good prognosis group.Multivariate analysis showed that hypertension history,stenosis degree,collateral circulation status,cholesterol level,platelet count,lesion's length and preoperative NIHSS score were the independent influencing factors for the prognosis of patients with symptomatic severe intracranial artery stenosis.The predicted AUC of the nomogram model was 0.931(95％ CI=0.873-0.989),and the calibration curve showed that the predicted value was in good agreement with the actual value.Conclusion Hypertension history,stenosis degree,collateral circulation status,cholesterol level,platelet count,lesion length and preoperative NIHSS score are the important influencing factors for the prognosis of patients with symptomatic severe intracranial artery stenosis.The nomogram prediction model constructed in this study shows a high accuracy in predicting the prognosis of patients,and it can provide important reference for clinical decision-making.
