Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan-si, Korea.
Medicine (Baltimore). 2023 May 26;102(21):e33866. doi: 10.1097/MD.0000000000033866.
Intra-arterial thrombectomy (IAT) has been increasingly applied in the treatment of acute ischemic stroke (AIS) due to large-vessel occlusion, and many related studies have been published. However, limited studies on the prognosis of failed-IAT patients are available. In this study, factors that can predict a good prognosis in patients with failed IAT were studied. Among patients who visited our hospital between January 2016 and September 2022 and underwent IAT, we retrospectively analyzed those with failed IAT. A univariate analysis was performed on the radiological features, medical histories, and other patient characteristics expected to affect the prognosis, and a multivariate analysis was performed on some of these factors. In univariate analysis, a good collateral channel on susceptibility-weighted imaging (SWI), modified thrombolysis in cerebral infarction (mTICI) 2A recanalization, and the pre-procedural modified Rankin scale (mRS) were statistically significant. In the multivariate analysis, good collateral channels on SWI and computed tomography angiography (CTA) and mTICI 2A recanalization were statistically significant. Factors that can predict a good prognosis in patients with failed IAT include good leptomeningeal collateral channels evaluated by CTA and SWI and mTICI 2A recanalization.
动脉内血栓切除术 (IAT) 已越来越多地应用于治疗大血管闭塞引起的急性缺血性脑卒中 (AIS),并发表了许多相关研究。然而,关于失败 IAT 患者预后的研究有限。在本研究中,我们研究了可以预测失败 IAT 患者预后良好的因素。在 2016 年 1 月至 2022 年 9 月期间在我院就诊并接受 IAT 的患者中,我们对失败 IAT 的患者进行了回顾性分析。对预计影响预后的影像学特征、病史和其他患者特征进行了单因素分析,并对其中一些因素进行了多因素分析。单因素分析显示,磁敏感加权成像 (SWI) 上良好的侧支循环、改良脑梗死溶栓 (mTICI) 2A 再通和术前改良 Rankin 量表 (mRS) 具有统计学意义。在多因素分析中,SWI 和计算机断层血管造影 (CTA) 上良好的侧支循环和 mTICI 2A 再通具有统计学意义。可以预测失败 IAT 患者预后良好的因素包括 CTA 和 SWI 评估的良好软脑膜侧支循环以及 mTICI 2A 再通。