Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing ShiJiTan Hospital, Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2024 Mar;30(3):e14588. doi: 10.1111/cns.14588.
With the progress of thrombectomy technology, the vascular recanalization rate of patients with stroke has been continuously improved, but the proportion of futile recanalization (FR) is still quite a few. The long-term prognosis and survival of patients with FR and its influencing factors remain unclear.
Consecutive patients who received endovascular treatment (EVT) for ischemic stroke were enrolled between 2013 and 2021 from a single-center prospectively registry study. We evaluated the long-term outcome of these patients by Kaplan-Meier survival analysis, and the multivariable logistic regression curve was performed to analyze influencing factors.
Among 458 patients with FR, 56.4% of patients survived at 1 year, and 50.4% at 2 years. In the multivariate regression analysis, age, premorbid modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), posterior circulation infarct, general anesthesia, symptomatic intracerebral hemorrhage (sICH), and decompressive craniectomy were found to be related to unfavorable outcomes in long-term. Age, premorbid mRS, NIHSS, general anesthesia, and sICH were predictors of long-term mortality.
Futile recanalization accounts for a large proportion of stroke patients after thrombectomy. This study on the long-term prognosis of such patients is beneficial to the formulation of treatment plans and the prediction of therapeutic effects.
随着取栓技术的进步,卒中患者的血管再通率不断提高,但无效再通(FR)的比例仍然相当高。FR 患者的长期预后和生存及其影响因素仍不清楚。
本研究纳入了 2013 年至 2021 年期间在单中心前瞻性登记研究中接受血管内治疗(EVT)的缺血性卒中连续患者。我们通过 Kaplan-Meier 生存分析评估这些患者的长期预后,并进行多变量逻辑回归曲线分析影响因素。
在 458 例 FR 患者中,56.4%的患者在 1 年内存活,50.4%的患者在 2 年内存活。多变量回归分析发现,年龄、发病前改良 Rankin 量表(mRS)、美国国立卫生研究院卒中量表(NIHSS)、后循环梗死、全身麻醉、症状性颅内出血(sICH)和去骨瓣减压术与长期不良结局相关。年龄、发病前 mRS、NIHSS、全身麻醉和 sICH 是长期死亡率的预测因素。
取栓后 FR 占卒中患者的很大比例。这项对这类患者长期预后的研究有助于制定治疗计划和预测治疗效果。