PDF(Pubmed)
Abstract：
Although the efficacy of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) has been established in two randomized controlled studies, many patients have miserable clinical outcomes after MT for ABAO. Predicting severe disability prior to the procedure might be useful in determining the appropriateness of treatment interventions. Among the ABAO cases treated at 10 hospitals between July 2014 and December 2021, 144 were included in the study, all of whom underwent MRI before treatment. A miserable outcome was defined as a modified Rankin Scale (mRS) of 5-6 at 3 months. The associations between clinical, imaging, and procedural factors and miserable outcomes were evaluated. A miserable outcome was observed in 54 cases (37.5%). Multivariate analysis identified the National Institutes of Health Stroke Scale (NIHSS), transverse diameter of brainstem infarction, and symptomatic intracerebral hemorrhage as independent factors associated with miserable outcomes, with cutoff values of NIHSS 22 and transverse diameter of brainstem infarction 15 mm. Cases with a higher preoperative severity may result in miserable postoperative outcomes. Particularly, the transverse diameter of a brainstem infarction can be easily measured and serves as a useful criterion for determining treatment indications.
摘要：
尽管在两项随机对照研究中已经建立了机械血栓切除术（MT）对急性基底动脉闭塞（ABAO）的疗效，许多患者在接受ABAOMT治疗后的临床结局不佳.在手术前预测严重残疾可能有助于确定治疗干预措施的适当性。在2014年7月至2021年12月期间在10家医院接受治疗的ABAO病例中，有144例被纳入研究。所有患者在治疗前均接受了MRI检查。不良结果定义为3个月时5-6的改良Rankin量表（mRS）。临床，成像,评估了程序因素和悲惨结局。54例（37.5％）观察到悲惨的结果。多变量分析确定了美国国立卫生研究院卒中量表(NIHSS)，脑干梗死横径,和症状性脑出血作为与不良结局相关的独立因素，NIHSS22和脑干梗死横径15mm的截止值。术前严重程度较高的病例可能会导致不良的术后结局。特别是,脑干梗死的横径可以很容易地测量，并作为确定治疗适应症的有用标准。
