Predictors of favorable outcomes for vertebrobasilar artery occlusion after endovascular therapy within 24 hours of symptom onset

被引：4

作者：

Jiang, Changchun ^{[1
]}

Fan, Yu ^{[1
]}

Li, Yuechun ^{[1
]}

Hao, Fei ^{[1
]}

Yang, Junfeng ^{[1
]}

Wang, Baojun ^{[1
]}

Zhang, Tianyou ^{[1
]}

Li, Xia ^{[1
]}

Liu, Jiahui ^{[1
]}

Wang, Shuguang ^{[1
]}

机构：

[1] Baotou Cent Hosp, Dept Neurol, 61 Huanchenglu, Baotou 014040, Inner Mongolia, Peoples R China

来源：

CLINICAL NEUROLOGY AND NEUROSURGERY | 2021年 / 201卷

关键词：

Acute ischemic stroke; Vertebrobasilar occlusion; Endovascular therapy; Outcome;

D O I：

10.1016/j.clineuro.2020.106422

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: The aim of the present study was to describe our results of endovascular therapy (EVT) for vertebrobasilar artery occlusion (VBAO) within 24 h of symptom onset, and to evaluate prognostic factors associated with favorable outcomes. Methods: The present study enrolled patients who underwent EVT for acute ischemic stroke (AIS) caused by VBAO. Inclusion criteria for EVT to treat VBAO were as follows: (1) computed tomography angiography (CTA) or magnetic resonance angiography (MRA) confirmed acute VBAO; (2) baseline National Institutes of Health Stroke Scale (NIHSS) score >2; (3) premorbid modified Rankin scale (mRS) score <= 2; (4) onset or last known time to puncture within 24 h; and (5) posterior-circulation Acute Stroke Prognosis Early CT score (pc-ASPECTS) >6. Favorable outcomes were defined as mRS scores of 0-3 at three months following EVT. The associations among baseline parameters, procedural parameters, and favorable outcomes were assessed. Results: A total of 67 patients were recruited in this study, of which 40 patients (59.7 %) had favorable outcomes. Of the 50 patients with a late-window (6-24 h), 29 patients (58 %) had favorable outcomes. Univariate analysis revealed significant associations of the following parameters with favorable outcomes in the enrolled patients: age, sex, smoking status, baseline NIHSS score, baseline Glasgow coma scale (GCS) score, Pons-midbrain index (PMI), and intracranial atherosclerosis (ICAS). Multivariate logistic regression indicated that only age (OR 0.914, 95 % CI: 0.849 to 0.984; p = 0.017), baseline GCS score (OR 1.234, 95 % CI: 1.061-1.435; p = 0.006), and PMI (OR 0.448, 95 % CI: 0.252 to 0.798; p = 0.006) were independently associated with favorable outcomes at three months following EVT. After adjustments for confounding factors in patients with a late-window, only age (OR 0.879, 95 % CI: 0.799 to 0.967; p = 0.008) was associated with favorable outcomes. Conclusions: Younger age, lower PMI, and higher GCS scores in patients with VBAO-induced AIS were associated with more favorable outcomes. In late-window (6-24 h) patients, younger age associated to favorable outcomes, and lower NIHSS scores and lower PMI each also had a tendency to associated with favorable outcomes.

引用

页数：6

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