Shang Wenjin, Zhong Kaiyi, Shu Liming, Li Zhuhao, Hong Hua
Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China.
Department of Neurology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China.
Brain Sci. 2022 Dec 23;13(1):32. doi: 10.3390/brainsci13010032.
Many patients show poor outcomes following endovascular reperfusion therapy (ERT), and poor cortical venous outflow is a risk factor for these poor outcomes. We investigated the association between the outflow of the internal jugular vein (IJV) and baseline cortical venous outflow and the outcomes after ERT. We retrospectively enrolled 78 patients diagnosed with an acute anterior circulation stroke and successful ERT. Poor IJV outflow on the affected side was defined as stenosis ≥50% or occlusion of ipsilateral IJV, and poor outflow of bilateral IJVs was defined as stenosis ≥50% or occlusion of both IJVs. Poor cortical venous outflow was defined as a cortical vein opacification score (COVES) of 0 on admission. Multivariate analysis showed that poor outflow of IJV on the affected side was an independent predictor for hemorrhagic transformation. The poor outflow of bilateral IJVs was an independent risk factor for poor clinical outcomes. These patients also had numerical trends of a higher incidence of symptomatic intracranial hemorrhage, midline shift >10 mm, and in-hospital mortality; however, statistical significance was not observed. Additionally, poor IJV outflow was an independent determinant of poor cortical venous outflow. For acute large vessel occlusion patients, poor IJV outflow is associated with poor baseline cortical venous outflow and outcomes after successful ERT.
许多患者在接受血管内再灌注治疗（ERT）后预后不佳，而皮质静脉流出不畅是导致这些不良预后的一个危险因素。我们研究了颈内静脉（IJV）流出与基线皮质静脉流出之间的关联以及ERT后的预后情况。我们回顾性纳入了78例诊断为急性前循环卒中且ERT成功的患者。患侧IJV流出不畅定义为同侧IJV狭窄≥50%或闭塞，双侧IJV流出不畅定义为双侧IJV狭窄≥50%或闭塞。皮质静脉流出不畅定义为入院时皮质静脉不显影评分（COVES）为0。多因素分析显示，患侧IJV流出不畅是出血转化的独立预测因素。双侧IJV流出不畅是临床预后不良的独立危险因素。这些患者在症状性颅内出血、中线移位>10 mm和院内死亡率方面也有更高发生率的数值趋势；然而，未观察到统计学意义。此外，IJV流出不畅是皮质静脉流出不畅的独立决定因素。对于急性大血管闭塞患者，IJV流出不畅与基线皮质静脉流出不畅及ERT成功后的预后相关。
