Abstract：
Although consensus has been reached regarding the use of mechanical thrombectomy for acute large anterior circulation occlusion, its effectiveness in patients with posterior circulation occlusion remains unclear. This study aimed to establish the determining factors for good clinical outcomes of mechanical thrombectomy for posterior circulation occlusion.
We extracted cases of acute large vessel occlusion (LVO) in the posterior circulation from a database comprising 536 patients who underwent mechanical thrombectomy at our hospital between April 2015 and March 2021.
Fifty-two patients who underwent mechanical thrombectomy for LVO in the posterior circulation were identified. Five patients with simultaneous occlusion of the anterior and posterior circulation were excluded; finally, 47 patients were included in this study. The median patient age was 78 years, and 36% of the patients were women. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 31, the median posterior circulation-Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS) was 8, and the median Basilar Artery on Computed Tomography Angiography (BATMAN) score was 6. The rate of good recanalization (Thrombolysis in Cerebral Infarction scale grades 2b and 3) was 96%, and a good prognosis (modified Rankin Scale score of 0-2 at 90 days) was achieved in 19 patients (40%). The median pc-ASPECTS was significantly higher in the good prognosis group than in the poor prognosis group (10 vs. 7; p = 0.007). The median NIHSS score at presentation was significantly lower in the good prognosis group than in the poor prognosis group (17 vs. 34; p = 0.02). The median BATMAN score was significantly higher in the good prognosis group than in the poor prognosis group (8 vs. 3.5; p = 0.0002). Multivariate analysis showed that an NIHSS score ≦ 20 at presentation was the only independent factor for good prognoses.
The prognosis of mechanical thrombectomy for posterior circulation LVO was better in patients with lower NIHSS scores at presentation.
We extracted cases of acute large vessel occlusion (LVO) in the posterior circulation from a database comprising 536 patients who underwent mechanical thrombectomy at our hospital between April 2015 and March 2021.
Fifty-two patients who underwent mechanical thrombectomy for LVO in the posterior circulation were identified. Five patients with simultaneous occlusion of the anterior and posterior circulation were excluded; finally, 47 patients were included in this study. The median patient age was 78 years, and 36% of the patients were women. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 31, the median posterior circulation-Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS) was 8, and the median Basilar Artery on Computed Tomography Angiography (BATMAN) score was 6. The rate of good recanalization (Thrombolysis in Cerebral Infarction scale grades 2b and 3) was 96%, and a good prognosis (modified Rankin Scale score of 0-2 at 90 days) was achieved in 19 patients (40%). The median pc-ASPECTS was significantly higher in the good prognosis group than in the poor prognosis group (10 vs. 7; p = 0.007). The median NIHSS score at presentation was significantly lower in the good prognosis group than in the poor prognosis group (17 vs. 34; p = 0.02). The median BATMAN score was significantly higher in the good prognosis group than in the poor prognosis group (8 vs. 3.5; p = 0.0002). Multivariate analysis showed that an NIHSS score ≦ 20 at presentation was the only independent factor for good prognoses.
The prognosis of mechanical thrombectomy for posterior circulation LVO was better in patients with lower NIHSS scores at presentation.
摘要：
目的：虽然对于机械取栓治疗急性大的前循环闭塞已经达成共识，其对后循环闭塞患者的有效性尚不清楚.本研究旨在确定机械取栓治疗后循环闭塞的良好临床效果的决定因素。
方法：我们从2015年4月至2021年3月在我院接受机械血栓切除术的536例患者的数据库中提取了后循环急性大血管闭塞（LVO）病例。
结果：52例患者在后循环中接受了LVO的机械血栓切除术。5例同时闭塞前后循环的患者被排除在外；最后，本研究包括47名患者。患者年龄中位数为78岁，36％的患者是女性。入院时美国国立卫生研究院卒中量表（NIHSS）评分中位数为31分，后循环-艾伯塔省卒中计划早期计算机断层扫描（pc-ASPERTS）评分中位数为8分，基底动脉计算机断层扫描血管造影（BATMAN）评分中位数为6分。良好的再通率（脑梗死溶栓评分2b级和3级）为96％，19例患者（40％）预后良好（90天时改良的Rankin量表评分为0-2）。预后良好组的pc-ASPERTS中位数明显高于预后不良组（10vs.7；p=0.007）。预后良好组的NIHSS评分中位数明显低于预后不良组（17vs.34；p=0.02）。预后良好组的中位BATMAN评分明显高于预后不良组（8vs.3.5；p=0.0002）。多变量分析显示，NIHSS评分≤20是良好预后的唯一独立因素。
结论：NIHSS评分较低的患者，机械取栓治疗后循环LVO的预后较好。
方法：我们从2015年4月至2021年3月在我院接受机械血栓切除术的536例患者的数据库中提取了后循环急性大血管闭塞（LVO）病例。
结果：52例患者在后循环中接受了LVO的机械血栓切除术。5例同时闭塞前后循环的患者被排除在外；最后，本研究包括47名患者。患者年龄中位数为78岁，36％的患者是女性。入院时美国国立卫生研究院卒中量表（NIHSS）评分中位数为31分，后循环-艾伯塔省卒中计划早期计算机断层扫描（pc-ASPERTS）评分中位数为8分，基底动脉计算机断层扫描血管造影（BATMAN）评分中位数为6分。良好的再通率（脑梗死溶栓评分2b级和3级）为96％，19例患者（40％）预后良好（90天时改良的Rankin量表评分为0-2）。预后良好组的pc-ASPERTS中位数明显高于预后不良组（10vs.7；p=0.007）。预后良好组的NIHSS评分中位数明显低于预后不良组（17vs.34；p=0.02）。预后良好组的中位BATMAN评分明显高于预后不良组（8vs.3.5；p=0.0002）。多变量分析显示，NIHSS评分≤20是良好预后的唯一独立因素。
结论：NIHSS评分较低的患者，机械取栓治疗后循环LVO的预后较好。
