García Jurado P B, Bravo Rey I M, Jiménez Gómez E, Oteros Fernández R, Valverde Moyano R, Bravo-Rodríguez F A, Delgado Acosta F
Sección de Neurorradiología Diagnóstica y Terapéutica, Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Reina Sofía, Córdoba, España.
Sección de Neurorradiología Diagnóstica y Terapéutica, Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Reina Sofía, Córdoba, España.
Radiologia (Engl Ed). 2020 Jan-Feb;62(1):51-58. doi: 10.1016/j.rx.2019.06.002. Epub 2019 Aug 21.
To determine the rate of recanalization, functional outcome at three months, and independent prognostic factors in patients with posterior circulation strokes treated with stent-retrievers and to compare these results with those of patients in an earlier series treated with "classical methods".
This was a retrospective study of consecutive patients with posterior circulation strokes treated with stent-retrievers at our center between December 1, 2011 and May 1, 2018. The main outcome variables were the rate of recanalization according to the Thrombosis in Cerebral Infarction (TICI) scale and functional independence score 90 days after treatment according to the modified Rankin Scale (mRS). We analyzed demographics, cerebrovascular risk factors, clinical findings, and probable origin. Descriptive statistics and a binary logistic regression model were used to analyze the data.
We included 75 patients: 27 treated with "classical methods" and 48 treated with stent-retrievers (10 women; mean age, 63.9 years; median National Institute of Health Stroke Score, 15.8 (IQR 9-25); median Glasgow Coma Scale (GCS), 9.1 (IQR 6-14,5). TICI 2b-3 recanalization was achieved in 46 (95.8%) patients treated with stent-retrievers and in 15 (55.6%) patients treated with "classical methods" (p<0.0001). No significant differences were observed in the rate of patients achieving mRS 0-2 at 90 days (19 (39.6%) of those treated with stent-retrievers vs. 6 (22.2%) of those treated with "classical methods"). Mortality was lower among patients treated with stent-retrievers (14 (29.2% vs. 15 (55.6%) in those treated with "classical methods", p=0.024). GCS score was independently associated with mRS at 90 days (OR:0.67; 95%CI:0.5-0.91; p=0.01).
In patients with posterior circulation infarcts, treatment with stent-retrievers achieved high rates of recanalization and functional independence at 90 days. The rate of complications was similar to those reported in other studies. GCS is an independent predictor of functional independence at 90 days.
确定使用支架取栓器治疗的后循环卒中患者的再通率、三个月时的功能结局以及独立预后因素，并将这些结果与早期采用“传统方法”治疗的患者进行比较。
这是一项对2011年12月1日至2018年5月1日期间在本中心接受支架取栓器治疗的连续性后循环卒中患者的回顾性研究。主要结局变量是根据脑梗死血栓形成（TICI）量表的再通率以及治疗90天后根据改良Rankin量表（mRS）的功能独立评分。我们分析了人口统计学、脑血管危险因素、临床表现和可能的病因。使用描述性统计和二元逻辑回归模型分析数据。
我们纳入了75例患者：27例采用“传统方法”治疗，48例采用支架取栓器治疗（10名女性；平均年龄63.9岁；美国国立卫生研究院卒中量表中位数为15.8（四分位间距9 - 25）；格拉斯哥昏迷量表（GCS）中位数为9.1（四分位间距6 - 14.5）。采用支架取栓器治疗的46例（95.8%）患者和采用“传统方法”治疗的15例（55.6%）患者实现了TICI 2b - 3级再通（p<0.0001）。在90天时达到mRS 0 - 2的患者比例方面未观察到显著差异（采用支架取栓器治疗的患者中有19例（39.6%），采用“传统方法”治疗的患者中有6例（22.2%））。采用支架取栓器治疗的患者死亡率较低（14例（29.2%），而采用“传统方法”治疗的患者中有15例（55.6%），p = 0.024）。GCS评分与90天时的mRS独立相关（比值比：0.67；95%置信区间：0.5 - 0.91；p = 0.01）。
在后循环梗死患者中，使用支架取栓器治疗在90天时实现了较高的再通率和功能独立性。并发症发生率与其他研究报告的相似。GCS是90天时功能独立性的独立预测因素。
