刘露 1刘玉峰 1张笑然 1支中文 1汪雨倩 1潘虹 1赵连东 1陈春1
作者信息
- 1. 徐州医科大学附属淮安医院 神经内科,江苏 淮安 223002
- 折叠
摘要
Abstract
Objective To compare the prognostic and cognitive effects of direct aspiration first-pass thrombectomy(ADAPT)and stent retriever thrombectomy(SR)on patients with acute basilar artery occlusion(ABAO).Methods A total of 90 patients with ABAO from August 2019 to December 2022 in the department of neurology in our hospital were prospectively enrolled.According to the type of throm-bectomy,the patients were divided into ADAPT group(44 cases)and SR group(46 cases).The clinical data,surgery-related indicators,clinical outcome,adverse events,and cognitive function of the two groups were evaluated.The clinical outcome was evaluated with the 7-day NIHSS score and the 90-day mRS score;The cognitive function was analyzed via MoCA score at 6 months after stroke;The safety evaluation was evaluated with the incidence of adverse events and mortality.Univariate analysis and multivariate Logistic regression model were used to analyze the independent risk factors of adverse clinical prognosis and post-stroke cognitive impairment(PSCI)in ABAO patients.Results There were no significant differences in the successful vascular recanalization rate,NIHSS score at 7 days after surgery,good outcome rate at 90 days(mRS Score≤2 points),incidence of PSCI and incidence of adverse events follow-up for 6 months between the ADAPT group and the SR group(all P>0.05).But compared with the SR group,patients in the ADAPT group had lower number of attempts at recanalization,a shorter time from puncture to vascular recanalization,and a shorter time from onset to vascular re-canalization(all P>0.05).Multivariate logistic regression showed that diabetes history(OR=18.922,95%CI:2.787-128.474;P=0.003),baseline high NIHSS scores(OR=1.195,95%CI:1.088-1.316;P=0.000),and low pc-ASPECTS scores(OR=0.298,95%CI:0.154-0.576;P=0.000)were the independent risk factors for poor clinical prognosis in ABAO patients.Advanced age(OR=1.150,95%CI:1.034-1.279;P=0.010),long time from onset to vascular recanalization(OR=1.006,95%CI:1.000-1.012;P=0.035),baseline high NIHSS scores(OR=1.120,95%CI:1.039-1.208;P=0.003)and low pc-ASPECTS scores(OR=0.571,95%CI:0.355-0.918;P=0.021)were the independent risk factors for PSCI in ABAO patients.Conclusion Compared with the SR technique,ADAPT has the same effi-cacy and safety in patients with ABAO.Diabetes,baseline NIHSS scores,and low pc-ASPECTS scores are independent risk factors for the poor outcome in patients with ABAO.Advanced age,prolonged time from onset to vascular recanalization,baseline NIHSS scores,and low pc-ASPECTS scores can independently contribute to the onset of PSCI in patients with ABAO.关键词
卒中/基底动脉闭塞/机械取栓/ADAPT/支架取栓/临床预后Key words
stroke/basilar artery occlusion/mechanical thrombectomy/ADAPT/stent retriever thrombectomy/clinical prognosis分类
医药卫生
