Zhang Xueqian, Li Yang, Yin Kuochang, Hao Zhiwei, Fu Yidian, Yang Qishuo, Xu Guodong, Lv Peiyuan
Department of Neurology, Hebei Medical University, Shijiazhuang, China.
Department of Neurology, Hebei General Hospital, Shijiazhuang, China.
Front Neurol. 2025 Apr 11;16:1453841. doi: 10.3389/fneur.2025.1453841. eCollection 2025.
Endovascular recanalization and stenting has been used to treat patients with symptomatic chronic cerebral artery occlusion, including intracranial vertebrobasilar artery occlusion and internal carotid artery occlusion. Our challenge is to improve success rates and reduce the incidence of postoperative complications. This study sought to identify potential predictors for successful recanalization.
Our study included 103 consecutive patients between February 2021 and October 2024 with symptomatic chronic cerebral artery occlusion who were treated with endovascular recanalization. We recorded clinical information, laboratory and examination results, radiologic characteristics and procedural results of patients. Factors affecting surgical outcomes were analyzed by univariate and multivariate analyses.
A total of 103 consecutive CCAO recanalization attempts were performed from February 2021 to October 2024 in 103 patients (78 men; age 61.1 ± 11.1 years; range: 32-81 years) with overall technical success rate 68.9%. Patients had chronic comorbidities such as hypertension (78, 75.7%), diabetes mellitus (32, 31.10%), and cardiac disease (12, 11.7%). 38 (36.9%) had a history of smoking, and 23 (22.3%) had a history of drinking. The rate of overall intraoperative complication was 10.7% (11/103). Multivariate analysis showed that stump morphology, smoking history, duration from last neurologic event (longer than 6 months or not), age, NLR were significantly associated with successful recanalization. According to the coefficients of the prediction model, the technical success rates were 100, 66.7 and 11.1% in patients with ≤6, 6-10, ≥10 points, respectively.
The morphology of occluded stumps, duration from last neurologic event, age, smoking history and NLR can be used to predict the outcome of vascular recanalization.
血管内再通和支架置入术已被用于治疗有症状的慢性脑动脉闭塞患者，包括颅内椎基底动脉闭塞和颈内动脉闭塞。我们面临的挑战是提高成功率并降低术后并发症的发生率。本研究旨在确定成功再通的潜在预测因素。
我们的研究纳入了2021年2月至2024年10月期间连续103例接受血管内再通治疗的有症状慢性脑动脉闭塞患者。我们记录了患者的临床信息、实验室和检查结果、影像学特征及手术结果。通过单因素和多因素分析来分析影响手术结果的因素。
2021年2月至2024年10月期间，对103例患者（78例男性；年龄61.1±11.1岁；范围：32 - 81岁）连续进行了103次颈总动脉闭塞再通尝试，总体技术成功率为68.9%。患者有高血压（78例，75.7%）、糖尿病（32例，31.10%）和心脏病（12例，11.7%）等慢性合并症。38例（36.9%）有吸烟史，23例（22.3%）有饮酒史。总体术中并发症发生率为10.7%（11/103）。多因素分析显示，残端形态、吸烟史、距上次神经事件的时间（超过6个月与否）、年龄、中性粒细胞与淋巴细胞比值与成功再通显著相关。根据预测模型的系数，评分≤6分、6 - 10分、≥10分的患者技术成功率分别为100%、66.7%和11.1%。
闭塞残端的形态、距上次神经事件的时间、年龄、吸烟史和中性粒细胞与淋巴细胞比值可用于预测血管再通的结果。
