Predictive factors of poor prognosis in patients with acute basilar artery occlusion who got first-pass effect after mechanical thrombectomy
10.13929/j.issn.1672-8475.2025.02.001
- VernacularTitle:急性基底动脉闭塞患者经机械取栓获得首过效应后预后不良预测因素
- Author:
Yun DING
1
;
Yuan MA
;
Penghua LYU
;
Peicheng LI
;
Bo LI
;
Chen YUAN
;
Wanci LI
;
Dianyi GU
;
Long CHEN
Author Information
1. 苏州大学附属第一医院介入放射科,江苏 苏州 215006
- Publication Type:Journal Article
- Keywords:
brain infarction;
basilar artery;
mechanical thrombolysis;
prognosis
- From:
Chinese Journal of Interventional Imaging and Therapy
2025;22(2):81-85
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the predictive factors of poor prognosis in patients with acute basilar artery occlusion(BAO)who got first-pass effect(FPE)after mechanical thrombectomy(MT).Methods Eighty-two acute BAO patients who got FPE following MT were retrospectively collected and divided into good prognosis group(modified Rankin scale[mRS]score≤3,n=48)and poor prognosis group(mRS score＞3,n=34)90 days after treatments.The data were compared between groups,and variables which showed P＜0.1 were included in multivariate logistic regression analysis to identify independent predictors of poor prognosis in acute BAO patients who got FPE after MT.Results Higher age of patients,pre-treatment National Institute Health stroke scale(NIHSS)and neutrophil-to-lymphocyte ratio(NLR),also higher proportions of patients with diabetes mellitus,atrial fibrillation(AF)and cardioembolic stroke in trial of org 10 172 in acute stroke treatment(TOAST)classification were found in poor prognosis group than those in good prognosis group(all P＜0.05).Conversely,patients in poor prognosis group had lower pre-treatment Glasgow coma scale(GCS)scores,lower posterior circulation-Alberta stroke program early CT score(pc-ASPECTS)and basilar artery on CT angiography(BATMAN)scores(all P＜0.05).Multivariate logistic regression analysis revealed patients complicated with AF(OR[95%CI]=29.769[1.470,602.943])and elevated pre-treatment NLR(OR[95%CI]=1.212[1.016,1.446])had relatively poor prognosis(both P＜0.05),whereas those with increased pre-treatment GCS score(OR[95%CI]=0.615[0.429,0.882]),elevated pc-ASPECTS(OR[95%CI]=0.263[0.092,0.748])and higher BATMAN score(OR[95%CI]=0.260[0.085,0.796])had relatively better prognosis(all P＜0.05).Conclusion Complicated with AF,low pre-treatment GCS score,high NLR,low pc-ASPECTS and low BATMAN score were all predictive factors for poor prognosis in acute BAO patients who got FPE after MT.
