Jeong Hyeon Yeong, Nam Taek Min, Lee Sang Hyuk, Jang Ji Hwan, Kim Young Zoon, Kim Kyu Hong, Ryu Kyeong Hwa, Kim Do-Hyung, Kwan Byung Soo, Bak Hyerang, Kim Seung Hwan
Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Republic of Korea.
Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Republic of Korea.
J Clin Med. 2023 Sep 22;12(19):6115. doi: 10.3390/jcm12196115.
Vascular conditions can affect the recanalization rates after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). Chest radiography can assess the conditions of the aortic arch based on the presence or absence of aortic arch calcification (AoAC). The aim of this study was to investigate the relationship between AoAC on chest radiography and first-pass successful recanalization (modified thrombolysis in cerebral infarction 2b/3 after the first-pass).
We compared the rate of first-pass successful recanalization between patients with and without AoAC. A total of 193 patients with anterior circulation occlusion who underwent EVT between January 2017 and December 2021 were included.
AoAC was observed in 80 (41.5%) patients. Patients with AoAC were older (74.5 ± 7.78 vs. 63.9 ± 12.4 years, < 0.001), had more EVT attempts (3.04 ± 1.95 vs. 2.01 ± 1.34 times, < 0.001), and a longer procedural time (71.7 ± 31.2 vs. 48.7 ± 23.1 min, < 0.001) than those without AoAC. Moreover, Patients with AoAC showed a lower incidence of first-pass successful recanalization (18.8% vs. 47.8%, < 0.001) and a higher incidence of postprocedural hemorrhage (45.0% vs. 27.7%, = 0.015) than those without AoAC. On multivariate analysis, AoAC was independently associated with first-pass successful recanalization (odds ratio: 0.239 [0.121-0.475], < 0.001).
AoAC on chest radiography can be used as a preoperative predictor of successful first-pass recanalization in patients undergoing EVT for AIS.
血管状况可影响急性缺血性卒中（AIS）血管内血栓切除术（EVT）后的再通率。胸部X线摄影可根据主动脉弓钙化（AoAC）的有无来评估主动脉弓状况。本研究的目的是探讨胸部X线摄影上的AoAC与首次通过成功再通（首次通过后改良脑梗死溶栓2b/3级）之间的关系。
我们比较了有和没有AoAC的患者的首次通过成功再通率。纳入了2017年1月至2021年12月期间接受EVT的193例前循环闭塞患者。
80例（41.5%）患者观察到AoAC。与没有AoAC的患者相比，有AoAC的患者年龄更大（74.5±7.78岁对63.9±12.4岁，P<0.001），EVT尝试次数更多（3.04±1.95次对2.01±1.34次，P<0.001），手术时间更长（71.7±31.2分钟对48.7±23.1分钟，P<0.001）。此外，与没有AoAC的患者相比，有AoAC的患者首次通过成功再通的发生率更低（18.8%对47.8%，P<0.001），术后出血的发生率更高（45.0%对27.7%，P=0.015）。多因素分析显示，AoAC与首次通过成功再通独立相关（比值比：0.239[0.121-0.475]，P<0.001）。
胸部X线摄影上的AoAC可作为接受AIS-EVT患者首次通过成功再通的术前预测指标。
