Recanalization of occluded blood vessels and influencing factors in patients with acute ischemic cerebral infarction after the first stent thrombectomy
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目的 分析急性缺血性脑梗死患者首次支架取栓治疗后闭塞血管的再通情况及影响因素。 方法 回顾性队列研究。抽取2021年5月至2023年6月在商丘市第一人民医院接受首次支架取栓治疗的急性缺血性脑梗死患者128例，观察首次支架取栓治疗后闭塞血管再通情况，并分析其影响因素。 结果 128例急性缺血性脑梗死患者中，首次支架取栓治疗后闭塞血管再通41例(32.03%)，纳入FPR组；其余87例纳入非FPR组。两组静脉溶栓、闭塞位置、使用中间导管、改良脑梗死溶栓治疗分级血流分级、穿刺以及发病至再通时间、90 d改良Rankin量表(mRS)评分≤2比较，差异有统计学意义(P<0.05)；将上述有差异的资料带入Logistic回归方程计算，发现闭塞位置、术前静脉溶栓、使用中间导管均属于急性缺血性脑梗死患者首次支架取栓治疗后闭塞血管再通的影响因素。 结论 急性缺血性脑梗死患者首次支架取栓治疗后闭塞血管再通与临床良好预后有关，在支架取栓过程中使用中间导管、大脑中动脉闭塞、术前行静脉溶栓会增加首次支架取栓治疗后闭塞血管再通的可能性。 Objective To analyze the recanalization of occluded blood vessels and its influencing factors in patients with acute ischemic cerebral infarction after the first stent thrombectomy. Methods This retrospective cohort study was conducted on a total of 128 patients with acute ischemic cerebral infarction who received the first stent thrombectomy treatment in First People’s Hospital of Shangqiu from May 2021 to June 2023. The recanalization of occluded blood vessels after the first stent thrombectomy treatment was observed, and the influencing factors were analyzed. Results Among the 128 patients with acute ischemic cerebral infarction, 41 cases (32.03%) underwent recanalization of occluded blood vessels after the first stent thrombectomy treatment, and they were included into FPR group while the rest 87 cases were included into non-FPR group. There were significant differences in proportions of venous thrombolysis, occlusion location, use of intermediate catheters, blood flow grading evaluated by modified thrombolysis in cerebral infarction score, time from puncture and onset to reperfusion, 90-day modified Rankin scale (mRS) score ≤2 between the two groups (P<0.05). By incorporating the above differential data into the logistic regression equation calculation, it was found that occlusive location, preoperative intravenous thrombolysis, and use of intermediate catheters were all influencing factors of recanalization of occluded blood vessels in patients with acute ischemic stroke after the first stent thrombectomy. Conclusions The recanalization of occluded vessels in patients with acute ischemic cerebral infarction after the first stent thrombectomy is related to a good clinical prognosis. The use of intermediate catheters, occlusion of the middle cerebral artery, and preoperative intravenous thrombolysis can increase the likelihood of recanalization of occluded vessels after the first stent thrombectomy.
Objective To analyze the recanalization of occluded blood vessels and its influencing factors in patients with acute ischemic cerebral infarction after the first stent thrombectomy. Methods This retrospective cohort study was conducted on a total of 128 patients with acute ischemic cerebral infarction who received the first stent thrombectomy treatment in First People’s Hospital of Shangqiu from May 2021 to June 2023. The recanalization of occluded blood vessels after the first stent thrombectomy treatment was observed, and the influencing factors were analyzed. Results Among the 128 patients with acute ischemic cerebral infarction, 41 cases (32.03%) underwent recanalization of occluded blood vessels after the first stent thrombectomy treatment, and they were included into FPR group while the rest 87 cases were included into non-FPR group. There were significant differences in proportions of venous thrombolysis, occlusion location, use of intermediate catheters, blood flow grading evaluated by modified thrombolysis in cerebral infarction score, time from puncture and onset to reperfusion, 90-day modified Rankin scale (mRS) score ≤2 between the two groups (P<0.05). By incorporating the above differential data into the logistic regression equation calculation, it was found that occlusive location, preoperative intravenous thrombolysis, and use of intermediate catheters were all influencing factors of recanalization of occluded blood vessels in patients with acute ischemic stroke after the first stent thrombectomy. Conclusions The recanalization of occluded vessels in patients with acute ischemic cerebral infarction after the first stent thrombectomy is related to a good clinical prognosis. The use of intermediate catheters, occlusion of the middle cerebral artery, and preoperative intravenous thrombolysis can increase the likelihood of recanalization of occluded vessels after the first stent thrombectomy.
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