1.Relationship between CIS and outcome after endovascular stent implantation in patients with middle cerebral artery M1 segment stenosis
Xiuxiao CHEN ; Chao NIU ; Qian JIA ; Bogang ZHANG ; Zhongjun DONG ; Xige YAN
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(10):1359-1362
Objective To analyze the relationship of capillary index score(CIS)with postoperative outcome in the patients with middle cerebral artery(MCA)M1 segment stenosis after endovascu-lar stent implantation.Methods A total of 122 eligible patients in our hospital from April 2021 to April 2023 were retrospectively recruited,and according to postoperative status,they were classi-fied into a good prognosis group(89 cases)and a poor prognosis group(33 cases).The clinical data were collected,and the preoperative and postoperative CIS values were evaluated.Spearman correlation analysis was applied to analyze the correlation of CIS with prognosis of the patients.ROC curve was plotted to evaluate the value of CIS in predicting postoperative prognosis,and multivariate logistic regression analysis was utilized to analyze the factors affecting the postopera-tive prognosis.Results The poor prognosis group exhibited significantly lower CIS,and larger proportions of aged ≥75 years,diabetes and history of stroke than the good prognosis group(P<0.05,P<0.01).Spearman correlation analysis found that CIS was positively correlated with prog-nosis after endovascular stent implantation in the patients with MCA M1 segment stenosis(r=0.446,P=0.000).ROC curve analysis revealed that the AUC,cut-off value,sensitivity and speci-ficity of CIS in predicting the postoperative outcomes in these patients was 0.790(95%CI:0.706-0.858),2.17,84.85%and 66.29%,respectively(P<0.05).Multivariate logistic analysis suggested that age ≥75 years,history of stroke,and concurrent diabetes were high risk factors for poor prognosis in the patients after endovascular stent implantation(P<0.05,P<0.01),and CIS was a protective factor(OR=0.439,95%CI:0.294-0.655,P=0.000).Conclusion CIS is closely correlated with the prognosis of patients with MCA M1 segment stenosis after endovascular stent implantation.Early evaluation of CIS can provide certain predictive value for postoperative out-comes of these patients.
2.Clinical value of transcranial color-coded duplex sonography in elderly patients with acute ischemic stroke after endovascular therapy
Jing TANG ; Juan HAN ; Chenghui LIU ; Bogang YAN ; Qin AO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(3):337-342
Objective To investigate the intracranial hemodynamic parameters with transcranial color-coded duplex sonography(TCCS)in elderly patients with acute ischemic stroke(AIS)after endovascular therapy,and analyze their association with functional outcomes.Methods A total of 360 elderly AIS patients undergoing endovascular therapy in our hospital from March 1,2020 to January 31,2024 were prospectively included,and according to the score of modified Rankin scale(mRS)at 90 d,they were divided into a poor function group(mRS score 3-6,145 cases)and good function group(mRS score≤2,215 cases).TCCS was conducted on all the patients in 12 h after endovascular therapy to evaluate intracranial blood flow status.Peak systolic velocity(PSV),end-diastolic velocity(EDV),mean blood flow velocity(MFV),pulsatility index(PI),MFV ratio and PSV ratio,adjusted PSV ratio and adjusted MFV ratio were recorded in all pa-tients.Receiver operator characteristic(ROC)curve analysis was employed to analyze the value of TCCS parameters in predicting poor functional outcomes,and the AUC values and cut-off values were also analyzed.Results The PSV ratio,MFV ratio,adjusted PSV ratio and adjusted MFV ra-tio were significantly higher in the poor function group than the good function group(P<0.01).The predictive performance of PSV ratio and MFV ratio were not good enough for poor functional outcome in the AIS patients(AUC<0.750),while the adjusted PSV ratio and adjusted MFV ratio showed better predictive performance(P<0.01).Multivariate logistic regression analysis showed that NIHSS score at admission ≥14.00,ASPECT score at admission≥8.00,adjusted PSV ratio>1.39 and adjusted MFV ratio>1.40 were independent risk factors for poor functional outcomes in AIS patients(P<0.01).ROC curve analysis indicated that combined NIHSS score at admission+ASPECT score at admission showed poor value in predicting poor functional outcome in the AIS(AUC=0.780,95%CI:0.734-0.822),the predictive performance of combination of above two scores+adjusted PSV ratio+adjusted MFV ratio was significantly improved(AUC=0.976,95%CI:0.955-0.989),with higher sensitivity and specificity(Z=8.261,P<0.01).Conclusion Early TCCS detection in elderly AIS patients after endovascular treatment is an effective method for identifying poor functional outcomes at 90 d,with the advantages of non invasiveness and easy op-eration.And,better predictive performance is obtained when adjusted PSV ratio and adjusted MFV ratio are combined with conventional predictors.
3.Clinical value of transcranial color-coded duplex sonography in elderly patients with acute ischemic stroke after endovascular therapy
Jing TANG ; Juan HAN ; Chenghui LIU ; Bogang YAN ; Qin AO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(3):337-342
Objective To investigate the intracranial hemodynamic parameters with transcranial color-coded duplex sonography(TCCS)in elderly patients with acute ischemic stroke(AIS)after endovascular therapy,and analyze their association with functional outcomes.Methods A total of 360 elderly AIS patients undergoing endovascular therapy in our hospital from March 1,2020 to January 31,2024 were prospectively included,and according to the score of modified Rankin scale(mRS)at 90 d,they were divided into a poor function group(mRS score 3-6,145 cases)and good function group(mRS score≤2,215 cases).TCCS was conducted on all the patients in 12 h after endovascular therapy to evaluate intracranial blood flow status.Peak systolic velocity(PSV),end-diastolic velocity(EDV),mean blood flow velocity(MFV),pulsatility index(PI),MFV ratio and PSV ratio,adjusted PSV ratio and adjusted MFV ratio were recorded in all pa-tients.Receiver operator characteristic(ROC)curve analysis was employed to analyze the value of TCCS parameters in predicting poor functional outcomes,and the AUC values and cut-off values were also analyzed.Results The PSV ratio,MFV ratio,adjusted PSV ratio and adjusted MFV ra-tio were significantly higher in the poor function group than the good function group(P<0.01).The predictive performance of PSV ratio and MFV ratio were not good enough for poor functional outcome in the AIS patients(AUC<0.750),while the adjusted PSV ratio and adjusted MFV ratio showed better predictive performance(P<0.01).Multivariate logistic regression analysis showed that NIHSS score at admission ≥14.00,ASPECT score at admission≥8.00,adjusted PSV ratio>1.39 and adjusted MFV ratio>1.40 were independent risk factors for poor functional outcomes in AIS patients(P<0.01).ROC curve analysis indicated that combined NIHSS score at admission+ASPECT score at admission showed poor value in predicting poor functional outcome in the AIS(AUC=0.780,95%CI:0.734-0.822),the predictive performance of combination of above two scores+adjusted PSV ratio+adjusted MFV ratio was significantly improved(AUC=0.976,95%CI:0.955-0.989),with higher sensitivity and specificity(Z=8.261,P<0.01).Conclusion Early TCCS detection in elderly AIS patients after endovascular treatment is an effective method for identifying poor functional outcomes at 90 d,with the advantages of non invasiveness and easy op-eration.And,better predictive performance is obtained when adjusted PSV ratio and adjusted MFV ratio are combined with conventional predictors.
4.Relationship between CIS and outcome after endovascular stent implantation in patients with middle cerebral artery M1 segment stenosis
Xiuxiao CHEN ; Chao NIU ; Qian JIA ; Bogang ZHANG ; Zhongjun DONG ; Xige YAN
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(10):1359-1362
Objective To analyze the relationship of capillary index score(CIS)with postoperative outcome in the patients with middle cerebral artery(MCA)M1 segment stenosis after endovascu-lar stent implantation.Methods A total of 122 eligible patients in our hospital from April 2021 to April 2023 were retrospectively recruited,and according to postoperative status,they were classi-fied into a good prognosis group(89 cases)and a poor prognosis group(33 cases).The clinical data were collected,and the preoperative and postoperative CIS values were evaluated.Spearman correlation analysis was applied to analyze the correlation of CIS with prognosis of the patients.ROC curve was plotted to evaluate the value of CIS in predicting postoperative prognosis,and multivariate logistic regression analysis was utilized to analyze the factors affecting the postopera-tive prognosis.Results The poor prognosis group exhibited significantly lower CIS,and larger proportions of aged ≥75 years,diabetes and history of stroke than the good prognosis group(P<0.05,P<0.01).Spearman correlation analysis found that CIS was positively correlated with prog-nosis after endovascular stent implantation in the patients with MCA M1 segment stenosis(r=0.446,P=0.000).ROC curve analysis revealed that the AUC,cut-off value,sensitivity and speci-ficity of CIS in predicting the postoperative outcomes in these patients was 0.790(95%CI:0.706-0.858),2.17,84.85%and 66.29%,respectively(P<0.05).Multivariate logistic analysis suggested that age ≥75 years,history of stroke,and concurrent diabetes were high risk factors for poor prognosis in the patients after endovascular stent implantation(P<0.05,P<0.01),and CIS was a protective factor(OR=0.439,95%CI:0.294-0.655,P=0.000).Conclusion CIS is closely correlated with the prognosis of patients with MCA M1 segment stenosis after endovascular stent implantation.Early evaluation of CIS can provide certain predictive value for postoperative out-comes of these patients.

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