Influencing factors for prognosis after emergency endovascular treatment of anterior circulation tandem lesions
Objective To investigate the efficacy of concurrent carotid artery stenting(CAS)in emergency endovascular treatment of anterior circulation tandem lesions and related influencing factors for prognosis.Methods A retrospective analysis was performed for the clinical data of 121 patients with anterior circulation tandem lesions who underwent emergency endovascular treatment in Linyi People's Hospital from January 2020 to December 2021,and intraoperative CT reperfusion injury was observed to decide whether concurrent CAS should be performed.The modified Rankin Scale(mRS)score on day 90 after surgery was used for evaluation,and then the patients were divided into good prognosis group(an mRS score of 0‒2)and poor prognosis group(an mRS score of 3‒6).The logistic regression analysis was used to investigate the influencing factors for the clinical prognosis of patients with anterior circulation tandem lesions after emergency endovascular treatment,including concurrent CAS.Results General clinical data were compared between the good prognosis group and the poor prognosis group,and the univariate analysis and multivariate binary logistic regression analysis showed that that preoperative CT ASPECTS score[odds ratio(OR)=1.207,95%confidence interval(CI)1.001‒1.456,P=0.049],time from disease onset to recanalization(OR=0.997,95%CI 0.995‒0.999,P=0.012),and symptomatic intracranial hemorrhage(OR=-3.057,95%CI 0.005‒0.411,P=0.006)were independent influencing factors for the prognosis of patients with anterior circulation tandem lesions after emergency endovascular treatment.Conclusion Exclusion of reperfusion injury based on intraoperative CT and concurrent CAS for anterior circulation tandem lesions do not increase the risk of hemorrhage,and presence of the risk of reperfusion injury based on intraoperative CT without stenting does not increase the risk of occlusion within a short period of time.There are no significant differences in 90-day good prognosis rate and mortality rate between the non-CAS group and the CAS group.High ASPECTS score is a protective factor for good prognosis in patients with anterior circulation tandem lesions,while a longer time from disease onset to recanalization and symptomatic intracranial hemorrhage are influencing factors for good prognosis.
Tandem lesionsCarotid artery stentingEndovascular treatmentPrognosis
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