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评价基底动脉粥样硬化性脑卒中患者的卒中机制、卒中复发和临床结局的影响:一项单中心回顾性观察研究。

Evaluation of the effect on stroke mechanism, stroke recurrence and clinical outcome in stroke patients with basilar artery atherosclerosis: A single centre retrospective observational study.

机构信息

Department of Neurology, Uludağ University Medicine Faculty, Bursa, Turkey.

Department of Radiology, Uludağ University Medicine Faculty, Bursa, Turkey.

出版信息

Sci Prog. 2024 Oct-Dec;107(4):368504241301519. doi: 10.1177/00368504241301519.

Abstract

OBJECTIVES

Basilar artery atherosclerotic plaque is the predominant cause of stroke in the posterior circulation. İscheamic stroke caused basilar artery atherosclerosis faces a high risk of recurrence despite optimal medical treatment, which might lie in the less than ideal recognition of underlying stroke mechanism and lack of individualized treatment for strokes of different mechanisms. We aim in this study to investigate the effect on stroke mechanism, stroke recurrence and clinical outcome in stroke patients with basilar artery atherosclerosis.

METHODS

In this study, 107 ischaemic stroke patients with atherosclerotic stenosis in the BA who were followed up in Uludag University Faculty of Medicine between 1 January 2019 and 1 January 2022. The study was conducted retrospectively and observationally.

RESULTS

According to the results of our study, the degree of stenosis in atherosclerotic stenosis of the symptomatic basilar artery was found to be an independent risk factor for stroke recurrence. Independent risk factors for unfavourable clinical outcomes in these patients were determined as female gender, stenosis being in the proximal segment, stroke mechanism being from artery to artery embolism, and congestive heart failure.

CONCLUSION

The most striking result of our study is that clinical outcome was found to be closely related to the female gender, the stroke mechanism being artery-to-artery embolism, and the stenosis is in the proximal segment. If stroke mechanisms were evaluated more clearly, it would likely help provide individualised treatments.

摘要

目的

基底动脉粥样硬化斑块是后循环中风的主要原因。尽管进行了最佳的药物治疗,基底动脉粥样硬化性缺血性中风仍面临高复发风险,这可能是由于对潜在中风机制的认识不足,以及缺乏针对不同机制中风的个体化治疗。本研究旨在探讨基底动脉粥样硬化性中风患者中风机制、中风复发和临床结局的影响。

方法

本研究纳入了 2019 年 1 月 1 日至 2022 年 1 月 1 日期间在乌尔法大学医学院接受随访的 107 例基底动脉粥样硬化性狭窄的缺血性中风患者。该研究为回顾性和观察性研究。

结果

根据我们的研究结果,症状性基底动脉粥样硬化性狭窄的狭窄程度是中风复发的独立危险因素。这些患者不良临床结局的独立危险因素为女性、近端节段狭窄、中风机制为动脉到动脉栓塞以及充血性心力衰竭。

结论

我们研究最显著的结果是发现临床结局与女性、动脉到动脉栓塞的中风机制以及近端节段狭窄密切相关。如果能更清楚地评估中风机制,可能有助于提供个体化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75c9/11585018/4f13b20e72ac/10.1177_00368504241301519-fig1.jpg

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