Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China; Department of Intervention Radiology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, 242 Guangji Road, Gusu District, Suzhou 215008, China.
Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
Clin Neurol Neurosurg. 2023 Feb;225:107605. doi: 10.1016/j.clineuro.2023.107605. Epub 2023 Jan 21.
The standard for computed tomography perfusion (CTP) assessment has not been well established in early acute ischemic stroke (AIS). We aimed to examine the prognostic factors for good outcomes in patients who received CTP, with an Alberta Stroke Program Early CT Score (ASPECTS) < 6 after endovascular thrombectomy (EVT) in the early time window (0-6 h).
We retrospectively reviewed 59 patients who met the criteria from October 2019 to April 2021. Based on the modified Rankin Score (mRS) at 90 days, the patients were divided into a good outcome group (mRS 0-2) and a poor outcome group (mRS 3-6). Baseline and procedural characteristics were collected for unilateral and multivariate regression analyses to explore the influencing factors for good outcomes.
Of the 59 patients included, good outcomes were observed in 21 (35.6%). Multivariate logistic regression analysis showed that smaller ischemic core volume (odds ratio [OR]: 0.950; 95% CI: 0.908-0.994; P = 0.026), lower National Institutes of Health Stroke Scale (NIHSS) score (OR: 0.750; 95% CI: 0.593-0.949; P = 0.017) and shorter stroke onset to reperfusion time (ORT) (OR: 0.981; 95% CI: 0.966-0.996; P = 0.016) were independent predictors for good outcomes at 90 days.
Smaller ischemic core volume based on CTP, lower NIHSS score and shorter ORT were significant independent predictors of good outcomes in patients with ASPECTS < 6 in the early time window after EVT.
在早期急性缺血性卒中（AIS）中，尚未建立计算机断层灌注（CTP）评估的标准。我们旨在研究血管内血栓切除术（EVT）后早期时间窗（0-6 小时）ASPECTS < 6 的患者接受 CTP 后的预后因素。
我们回顾性分析了 2019 年 10 月至 2021 年 4 月符合标准的 59 例患者。根据 90 天的改良 Rankin 评分（mRS），患者分为预后良好组（mRS 0-2）和预后不良组（mRS 3-6）。收集基线和手术特征进行单因素和多因素回归分析，以探讨影响良好预后的因素。
59 例患者中，21 例（35.6%）预后良好。多因素逻辑回归分析显示，缺血核心体积较小（比值比[OR]：0.950；95%置信区间：0.908-0.994；P=0.026）、NIHSS 评分较低（OR：0.750；95%置信区间：0.593-0.949；P=0.017）和较短的卒中发病至再灌注时间（ORT）（OR：0.981；95%置信区间：0.966-0.996；P=0.016）是 EVT 后早期 ASPECTS < 6 患者 90 天良好预后的独立预测因素。
基于 CTP 的较小缺血核心体积、较低的 NIHSS 评分和较短的 ORT 是 EVT 后早期时间窗 ASPECTS < 6 的患者良好预后的显著独立预测因素。
