Correlation Between Cerebral Congestion and Lesion Volume,Functional Outcome in Patients with Acute Stroke After Endo-vascular Therapy
Objective To explore the correlation between cerebral congestion and lesion volume,functional out-come in patients with acute ischemic stroke(AIS)after endovascular therapy.Methods A total of 180 AIS patients ad-mitted to the emergency center of the author's hospital from May 2021 to May 2024 were divided into congestion group(n=94)and non-congestion group(n=86)according to whether the brain was congestion within 6 h after endovascular therapy.The inducing factors,duration of attack and other basic information,diffusion weighted imaging(DWI)volume,hemorrhagic transformation(HT),ischemic core volumes(ICV),DWI lesion volume growth and other clinical data were compared between the two groups.The functional outcome of the two groups was evaluated by modified Rankin scale(mRS).Spearman correlation was used to analyze the correlation between cerebral congestion and DWI lesion volume growth within 6 h after endovascular therapy,and Kaplan-Meier curve was used to analyze the correlation between cere-bral congestion and functional outcome within 6 h and 24 h after endovascular therapy.Results The relative cerebral blood flow(rCBF)in congestion group was higher than that in ipsilateral non-congestion area within 6 h after endovascu-lar therapy(P＜0.05);at 24 after endovascular therapy,the rCBF of congestion area and ipsilateral non-congestion area decreased in congestion group,and the rCBF of congestion area was significantly higher than those of ipsilateral non-con-gestion area(P＜0.05).The volume of ICV and DWI lesions in congestion group was higher than those in non-congestion group within 6 h after endovascular therapy,and the proportion of new congestion and DWI lesions at 24 h after endovascular therapy were higher than those in non-congestion group(all P＜0.05).Spearman correlation a-nalysis showed that there was a strong correlation be-tween cerebral congestion and DWI lesion volume growth in AIS patients at 24 h after endovascular therapy(r=0.465,P＜0.05).There were 51 cases(54.26％)with poor prog-nosis in the congestion group and 38 cases(44.19％)with poor prognosis in the non-congestion group;Kaplan-Meier curve showed that there was no significant correlation between cerebral congestion and functional outcome in AIS patients within 6 h after endovascular therapy(x2=0.754,P＞0.05).Conclusion Cerebral congestion in AIS patients occurred within 6 h after endovascular therapy and was closely related to the growth of lesion volume.Early congestion is a poten-tial sign of cerebrovascular injury in patients,so doctor can choose adjuvant therapy to prevent reperfusion injury and pathological volume growth,so as to improve the prognosis of the disease.
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