串联病变对急性前循环大血管闭塞性缺血性脑卒中血管内治疗预后的影响
Effect of tandem lesion on the prognosis of endovascular treatment for acute anterior circulation large vessel occlusion ischemic stroke
张艳 1王幼萌 1王福星 1陈巨罗 1王国防1
作者信息
摘要
目的 探讨串联病变对急性前循环大血管闭塞性缺血性脑卒中血管内治疗预后的影响.方法 收集2021年6月-2022年9月在阜阳市人民医院接受急性期血管内治疗的前循环大血管闭塞性缺血性脑卒中患者的临床资料,应用二分类Logistic回归分析串联病变对前循环大血管闭塞性缺血性脑卒中血管内治疗预后的影响.结果 本研究共入组14例(15.56％)串联病变患者,其中11例(78.57％)发病机制为动脉粥样硬化,3例(21.43％)为血管夹层;10例(71.43％)采用逆行开通的方法,11例(78.57％)同期行颈动脉支架植入,3例(21.43％)合并出血性转化,12例(85.71％)实现完全血管再通,6例(42.86％)预后良好;二分类Logistic回归分析显示,串联病变(OR=1.119,95％CI=0.182～6.880,P=0.903)对急性前循环大血管闭塞性缺血性脑卒中血管内治疗的预后无显著影响,而基线美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分高(OR=1.230,95％CI=1.099～1.377,P＜0.001)、穿刺至血管再通时间长(OR=1.034,95％CI=1.010～1.059,P=0.006)和出血性转化(OR=22.326,95％CI=2.673～186.474,P=0.004)是导致其神经功能结局转归不良的独立危险因素.结论 串联病变对急性前循环大血管闭塞性缺血性脑卒中血管内治疗的预后无显著影响,而基线NIHSS评分高、穿刺至血管再通时间长和出血性转化是导致其转归不良的独立危险因素.
Abstract
Objective To explore effect of tandem lesion on the prognosis of endovascular treatment for acute anterior circulation large vessel occlusion ischemic stroke.Methods The clinical data of patients with anterior circulation large vessel occlusive ischemic stroke who received acute endovascular treatment in Fuyang People's Hospital from June 2021 to September 2022 were collected.Binary logistic regression was applied to analyze the impact of tandem lesion on the prognosis of endovascular treatment for acute anterior circulation large vessel occlusion ischemic stroke.Results In this study,14 patients(15.56％)with tandem lesions were enrolled.Among them,11(78.57％)had atherosclerosis as the pathogenesis,3(21.43％)had vascular dis-section,10(71.43％)had retrograde patency,11(78.57％)had carotid stent implantation at the same time,3(21.43％)had hemorrhagic transformation,12(85.71％)had complete vascular recanalization,and 6(42.86％)had good prognosis.The results of binary logistic regression analysis showed that tandem lesions(OR=1.119,95％CI=0.182～6.880,P=0.903)had no significant impact on the prognosis of endovascular treatment for acute anterior circulation large vessel occlusion ischemic stroke.The high baseline NIHSS score(OR=1.230,95％CI=1.099～1.377,P＜0.001),long time from puncture to vascular recanalization(OR=1.034,95％CI=1.010～1.059,P=0.006),and hemorrhagic transformation(OR=22.326,95％CI=2.673～186.474,P=0.004)are independent risk factors for poor neurological outcomes.Conclusion Tan-dem lesion have no significant impact on the prognosis of endovascular treatment for acute anterior circulation large vessel occlusion ischemic stroke,while high baseline NIHSS score,long puncture to vessel recanalization time,and hemorrhagic transformation are independent risk factors for poor prognosis.
关键词
前循环串联病变/颈动脉支架植入/血管再通/出血性转化/预后Key words
Anterior circulation tandem lesion/Carotid artery stent implantation/Vascular recanaliza-tion/Hemorrhagic transformation/Prognosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据