Relationship between collateral circulation and prognosis of acute ischemic stroke patients with successful recanalization after mechanical thrombectomy
Objective To explore the relationship between collateral circulation and the prognosis of acute ischemic stroke(AIS)patients with successful recanalization after mechanical thrombectomy.Methods A total of 75 AIS patients who received mechanical thrombectomy at the First Affiliated Hospital of Xinxiang Medical University from September 2020 to May 2022 were selected as the research subjects.The clinical data of the patients were collected.According to the modified Rankin scale(mRS)score at 90 days after operation,the patients were divided into the good prognosis group(mRS score≤2)and the poor prognosis group(mRS score ≥3).Univariate and multivariate logistic regression were used to analyze the factors affecting the prognosis of AIS patients with successful recanalization after mechanical thrombectomy.There were three types of collateral circulation:symmetrical collateral circulation,malignant collateral circulation,and other collateral circulation.The National Institutes of Health Stroke Scale(NIHSS)score at admission,the NIHSS score at discharge and changes of the NIHSS score of patients with different collateral circulations were compared.Results Among the 75 patients,43 had a good prognosis,and 32 had a poor prognosis.The incidence of poor prognosis was 42.67％.Univariate analysis showed that history of diabetes,time from onset to puncture(OPT),collateral circulation and NIHSS score were the factors effecting the prognosis of AIS patients with successful recanalization after mechanical thrombectomy(P＜0.05).Age,sex,history of atrial fibrillation,history of hypertension,history of smoking,history of stroke,thrombolytic therapy and modified thrombolysis in cerebral infarction grade were not related to the prognosis of AIS patients with successful recanalization after mechanical thrombectomy(P＞0.05).Multivariate logistic regression analysis showed that symmetrical collateral circulation,malignant collateral circulation,history of diabetes and OPT were independent influencing factors for the prognosis of AIS patients with successful recanalization after mechanical thrombectomy(P＜0.05).There was no significant difference in the admission NIHSS score among the patients with different collateral circulations(P＞0.05).The discharge NIHSS score of patients with symmetrical collateral circulation was significantly lower than that of patients with malignant collateral circulation,and the change in the NIHSS score was more significant than that of patients with malignant collateral circulation(P＜0.05).There was no significant difference in the discharge NIHSS score and change in the NIHSS score between patients with symmetrical collateral circulation and patients with other collateral circulation(P＞0.05),and between patients with malignant collateral circulation and patients with other collateral circulation(P＞0.05).Conclusion Symmetrical collateral circulation,malignant collateral circulation are independent factor affecting the prognosis of AIS patients with successful recanalization after mechanical thrombectomy.Symmetrical collateral circulation may help improve the neurological function of patients after mechanical thrombectomy,and malignant collateral circulation may lead to deterioration of neurological function in patients undergoing mechanical thrombectomy.
维普
万方数据
