■血管内血栓切除术(EVT)是大血管闭塞(LVO)急性缺血性卒中(AIS)的现行标准;然而,尽管成功再灌注,但高达三分之二的EVT患者的功能结局较差.已经研究了许多放射学标志物作为AIS患者预后的预测性生物标志物。这项研究旨在确定哪些临床放射学因素与感兴趣的结果相关,以帮助选择LVOAIS的EVT患者。
■对2016年至2020年接受EVT的患者进行了回顾性研究。各种放射性变量的数据,如解剖参数,凝块特征,抵押品状态,和梗死面积,与传统的人口统计学和临床变量一起收集。对卒中后3个月功能独立性的主要结局(改良Rankin量表0-2)和院内死亡率和症状性颅内出血的次要结局进行单因素和多因素分析。
■该研究队列包括325例前循环LVOAIS患者(男性占54.5%),中位年龄为68岁(四分位距57-76)。NIHSS中位数为19。年龄,高血压,高脂血症,美国国立卫生研究院卒中量表(NIHSS),艾伯塔省mCTA得分,各方面,凝块长度,单因素分析显示,血栓HU和mTICI评分以及ICA和CCA之间的夹角与3个月时的功能结局相关.在多变量分析中,年龄,艾伯塔省mCTA侧支和NIHSS与功能结局显着相关,而各方面接近意义。
■在许多为接受EVT的超急性患者提出的放射学标志物中,现有的经过充分验证的临床放射学措施仍然与功能状态密切相关。
UNASSIGNED: Endovascular thrombectomy (EVT) is the current standard of care for large vessel occlusion (LVO) acute ischemic stroke (AIS); however, up to two-thirds of EVT patients have poor functional outcomes despite successful reperfusion. Many radiological markers have been studied as predictive biomarkers for patient outcomes in AIS. This study seeks to determine which clinico-radiological factors are associated with outcomes of interest to aid selection of patients for EVT for LVO AIS.
UNASSIGNED: A retrospective study of patients who underwent EVT from 2016 to 2020 was performed. Data on various radiological variables, such as anatomical parameters, clot characteristics, collateral status, and infarct size, were collected alongside traditional demographic and clinical variables. Univariate and multivariate analysis was performed for the primary outcomes of functional independence at 3 months post-stroke (modified Rankin Scale 0-2) and secondary outcomes of in-hospital mortality and symptomatic intracranial hemorrhage.
UNASSIGNED: The study cohort comprised 325 consecutive patients with anterior circulation LVO AIS (54.5% male) with a median age of 68 years (interquartile range 57-76). The median NIHSS was 19. Age, hypertension, hyperlipidaemia, National Institutes of Health Stroke Scale (NIHSS), Alberta mCTA score, ASPECTS, clot length, thrombus HU and mTICI score and the angle between ICA and CCA were associated with functional outcomes at 3 months on univariate analysis. On multivariate analysis, age, Alberta mCTA collaterals and NIHSS were significantly associated with functional outcomes, while ASPECTS approached significance.
UNASSIGNED: Among the many proposed radiological markers for patients in the hyperacute setting undergoing EVT, the existing well-validated clinico-radiological measures remain strongly associated with functional status.