Objective To explore the safety and effectiveness of step-by-step endovascular treatment in patients with acute large vessel occlusion(ALVO)caused by intracranial atherosclerotic stenosis(ICAS),and to further analyze the independent risk factors which affecting the prognosis.Methods A total of 55 patients with ICAS caused by ALVO who received step-by-step endovascular treatment at Fuyang People's Hospital from January 2021 to May 2023 were included.The process of step-by-step endovascular treatment included mechanical thrombectomy(MT),balloon angioplasty(BA),and rescue stenting(RS).Patients were divided into the MT+BA group and the MT+BA+RS group based on the combination method used during the treatment process.The baseline data and prognosis of the two groups of patients were compared.Binary logistic regression analysis was used to determine independent influencing factors on the prognosis of patients receiving step-by-step endovascular treatment.Results Compared with the MT+BA group,the MT+BA+RS group had younger age[(60.70±10.71)years vs(67.67±12.17)years,P=0.035],lower National Institute of Health Stroke Scale(NIHSS)score[(16.59±7.59)points vs(21.78±7.27)points,P=0.022],longer surgical time[(92.35±17.09)minutes vs(82.22±12.03)minutes,P=0.028].There was no significant difference between the two groups in terms of gender,hypertension,diabetes,atrial fibrillation,occlusive site,hemorrhagic transformation(HT),symptomatic intracranial hemorrhage(SICH),and the number of patients with good prognosis in three months and mortality(P＞0.05).Logistic regression analysis showed that high NIHSS score(OR=1.276,95％CI=1.112-1.464,P＜0.001),long surgical time(OR=1.064,95％CI=1.001-1.131,P=0.048),and HT(OR=0.067,95％CI=0.005-0.883,P=0.040)were independent risk factors for poor prognosis in patients undergoing step-by-step endovascular therapy.Conclusions ICAS caused by ALVO patients are safe and effective in receiving step-by-step endovascular treatment.High NIHSS score,long surgical time and HT are independent risk factors affecting their prognosis.
step-by-step endovascular treatmentintracranial atherosclerotic stenosisacute large vessel occlusionclinical prognosis
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