METHODS: We retrospectively identified consecutive adults with first-ever ischaemic stroke of anterior circulation who were treated with EVT. Futile recanalization was defined as poor 3-month functional status (modified Rankin scale score ≥ 3) despite complete or near-complete recanalization. Study outcome was the occurrence of PSE during the follow-up.
RESULTS: The study included 327 patients with anterior circulation ischaemic stroke treated with EVT. Futile recanalization occurred in 116 (35.5%) patients and 26 (8.0%) developed PSE during a median follow-up of 35 [interquartile range, 22.7-55.2] months. Futile recanalization was more common among patients who developed PSE compared to those who did not (76.9% versus 31.9%; p < 0.001). Futile recanalization [hazard ratio (HR) = 5.63, 95% confidence interval (CI): 1.88-16.84; p = 0.002], large artery atherosclerosis (HR = 3.48, 95% CI: 1.44-8.40; p = 0.006), cortical involvement (HR = 15.51, 95% CI: 2.06-116.98; p = 0.008), and acute symptomatic status epilepticus (HR = 14.40, 95% CI: 2.80-73.98; p = 0.001) increased the risk of PSE.
CONCLUSIONS: Futile recanalization after EVT is associated with increased risk of PSE in patients with ischaemic stroke due to occlusion of large vessel of the anterior circulation.
方法:我们回顾性地确定了接受EVT治疗的连续成人首次发生前循环缺血性卒中。Futille再通定义为尽管完全或接近完全再通,但3个月功能状态差(改良Rankin量表评分≥3)。研究结果为随访期间PSE的发生。
结果:本研究包括327例接受EVT治疗的前循环缺血性卒中患者。在中位随访35[四分位数范围内,116例(35.5%)患者发生了虚假再通,26例(8.0%)发生了PSE,22.7-55.2]个月。与未发生PSE的患者相比,发生PSE的患者更常见(76.9%对31.9%;p<0.001)。徒劳的再通[风险比(HR)=5.63,95%置信区间(CI):1.88-16.84;p=0.002],大动脉粥样硬化(HR=3.48,95%CI:1.44-8.40;p=0.006),皮质受累(HR=15.51,95%CI:2.06-116.98;p=0.008),和急性症状性癫痫持续状态(HR=14.40,95%CI:2.80-73.98;p=0.001)增加PSE的风险。
结论:在前循环大血管闭塞引起的缺血性卒中患者,EVT后Futtile再通与PSE风险增加相关。