PDF(Pubmed)
Abstract：
Acute basilar artery occlusion (ABAO) after endovascular treatment (EVT) is often associated with a poor prognosis, particularly in patients with cerebellar infarction who may develop malignant cerebellar edema. The present study aimed to investigate how massive cerebellar infarction (MCI) affects hospitalization outcomes in ABVO patients who undergo EVT. We conducted a retrospective study of ABVO patients who underwent EVT at our hospital between September 2017 and September 2022. MCI was diagnosed using imaging techniques, and various prognostic scores were assessed during hospitalization to examine the relationship between MCI and these outcomes. We identified 42 ABAO patients, of whom 22 (52.4%) had MCI. Patients with MCI had a higher modified Rankin Scale (mRS) score at discharge compared to those without MCI (4.36 ± 1.14 vs 3.05 ± 1.85, P = .042, odds ratio [OR] (95% confidence interval [CI]) = 1.093 (0.083, 2.103)), and a lower Glasgow Coma Scale score (6.59 ± 4.0 vs 10.10 ± 5.07, P = .036, OR (95% CI) = -3.444 (-6.518, -0.369)). MCI was identified as an independent risk factor for an extremely poor prognosis (mRS ≥ 5) at discharge (P = .036, OR (95% CI) = 15.531 (1.603, 313.026)) and for no improvement in mRS score compared to onset (P = .013, OR (95% CI) = 0.025 (0.001, 0.274)). Additionally, an extremely poor prognosis was independently associated with stent implantation, EVT duration, and body mass index, while mRS score improvement was correlated with EVT duration and pulmonary infection. MCI in ABAO patients is a significant independent risk factor for a poor prognosis at discharge and no improvement in function score compared to onset. Early diagnosis and intervention are necessary to improve outcomes, particularly in high-risk populations.
摘要：
血管内治疗（EVT）后急性基底动脉闭塞（ABAO）常伴有不良预后，特别是在可能发展为恶性小脑水肿的小脑梗死患者中。本研究旨在调查大面积小脑梗死（MCI）如何影响接受EVT的ABVO患者的住院结局。我们对2017年9月至2022年9月在我们医院接受EVT的ABVO患者进行了回顾性研究。MCI是使用成像技术诊断的，并在住院期间评估各种预后评分,以检查MCI与这些结局之间的关系.我们确定了42名ABAO患者，其中22人（52.4%）患有MCI。与没有MCI的患者相比，患有MCI的患者在出院时的改良Rankin量表（mRS）评分更高（4.36±1.14vs3.05±1.85，P=0.042，比值比[OR]（95％置信区间[CI]）=1.093（0.083，2.103）），格拉斯哥昏迷评分较低(6.59±4.0vs10.10±5.07,P=.036,OR(95%CI)=-3.444(-6.518,-0.369))。MCI被确定为出院时预后极差（mRS≥5）的独立危险因素（P=.036，OR（95％CI）=15.531（1.603，313.026）），与发病相比，mRS评分没有改善（P=.013，OR（95％CI）=0.025（0.001，0.274））。此外,极差的预后与支架植入独立相关,EVT持续时间,和身体质量指数,而mRS评分改善与EVT持续时间和肺部感染相关。ABAO患者的MCI是出院时预后差的重要独立危险因素，与发病相比，功能评分没有改善。早期诊断和干预是改善预后的必要条件。特别是在高危人群中。
