Lenticulostriate arteries appearance before thrombectomy predicts good outcome in acute middle cerebral artery occlusion

被引：6

作者：

Liu, Feifeng ^{[1
]}

Chen, Chen ^{[1
]}

Hong, Lan ^{[2
]}

Shen, Hao ^{[1
]}

Cao, Wenjie ^{[2
]}

Dong, Qiang ^{[2
]}

Yang, Xinyi ^{[1
]}

Guo, Mengruo ^{[1
]}

Li, Ying ^{[1
]}

Xiao, Yaping ^{[1
]}

Cheng, Xin ^{[2
]}

Li, Gang ^{[1
]}

机构：

[1] Tongji Univ, Shanghai East Hosp, Dept Neurol, Shanghai, Peoples R China

[2] Fudan Univ, Shanghai Huashan Hosp, Dept Neurol, Shanghai, Peoples R China

来源：

BMC NEUROLOGY | 2020年 / 20卷 / 01期

关键词：

Middle cerebral artery occlusion; Lenticulostriate artery; Thrombectomy; Outcome; Ischemic stroke; COMPUTED TOMOGRAPHIC PERFUSION; ACUTE ISCHEMIC-STROKE; EARLY CT SCORE; ENDOVASCULAR THROMBECTOMY; ALBERTA STROKE; BRAIN; HYPOPERFUSION; SELECTION; CORE;

D O I：

10.1186/s12883-020-01716-1

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background Endovascular therapy is widely used in acute large vessel occlusion. This study investigated whether imaging of lateral lenticulostriate arteries (LSAs) before thrombectomy would potentially be helpful for predicting prognosis of patients with acute M1 segment of middle cerebral artery occlusion (MCAO). Methods 59 consecutive patients with acute M1 segment of MCAO treated with mechanical thrombectomy at two comprehensive stroke centers were analyzed. Patients were categorized into LSA+ (appearing of lateral LSAs) and LSA- (sparing of lateral LSAs) group according to preprocedural digital substraction angiography (DSA). Baseline data and clinical outcomes were compared. A good clinical outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The association between clinical and imaging parameters and functional outcome was evaluated with logistic regression analysis. Results LSA+ was shown in 36 patients (61%). LSA+ group had a significantly higher proportion of good outcome (72.2% vs. 8.7%, OR 27.3,95% CI 5.38-138.4, P < 0.001), lower risk of symptomatic intracranial haemorrhages (sICH) (8.3% vs. 47.8%,OR 0.10,95% CI 0.02-0.42, P = 0.001) and lower mortality in hospital (5.6% vs. 34.8%, OR 0.11,95% CI 0.02-0.58, P < 0.004) compared with LSA- group. Patients in LSA+ group had lower baseline NIHSS score(P < 0.01) and NIHSS score at 14 days(P < 0.01) and smaller infarct core volume (P = 0.016) on computed tomography perfusion imaging (CTP) compared to the LSA- group. Multivariate logistic regression analysis showed that a small infarct core volume (OR 6.74,95% CI 1.148-39.569, P = 0.035) and LSA+(OR 22.114,95% CI 3.339-146.470, P = 0.001) were associated with a good clinical outcome. Conclusions Our data suggest that appearance of lateral LSAs before mechanical thrombectomy would be potentially helpful for predicting favorable prognosis of patients with acute M1 segment of MCAO.

引用

页数：7

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