Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS): prevalence and outcome
Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS): prevalence and outcome
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DOI：
10.1007/s00415-014-7583-5
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发表时间：
2015-02-01
影响因子：
6
通讯作者：
Schonewille, Wouter J.
中科院分区：
文献类型：
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作者：
Compter, Annette;van der Hoeven, Erik J. R. J.;Schonewille, Wouter J.
我们评估了急性基底动脉闭塞（BAO）患者椎动脉（VA）狭窄或闭塞的发生率及其对预后的影响。我们研究了141例颅底动脉国际合作研究（BASICS）注册的急性BAO患者，这些患者的颅底VAs基线CT血管造影（CTA）是可用的。在72例患者中，可获得颅外VAs的额外CTA。死亡和不良预后的调整风险比（aRRs），定义为修改的Rankin量表评分为千分之一，用泊松回归计算与VA闭塞、VA闭塞或狭窄a千分之一（50%）和双侧VA闭塞相关的aRRs。141例患者中有66例（47%）有单侧或双侧颅内VA闭塞或狭窄（千分之一）（50%）。在72例颅内外CTA患者中，46例（64%）单侧或双侧VA闭塞或狭窄（千分之一），9例（12%）双侧VA闭塞。总的来说，千分之一（50%）的VA闭塞或狭窄与预后不良的风险无关。颅内外CTA合并双侧VA闭塞的患者预后不良的风险高于无双侧VA闭塞的患者（aRR, 1.23; 95% CI 1.02-1.50）。死亡风险不取决于单侧或双侧VA闭塞或狭窄的存在（千分之一或50%）。总之，在急性BAO患者中，单侧VA闭塞或狭窄发生率为千分之一（50%），但与不良结局或死亡风险增加无关。BAO和双侧VA闭塞的患者预后不良的风险略有增加。
We assessed the prevalence of vertebral artery (VA) stenosis or occlusion and its influence on outcome in patients with acute basilar artery occlusion (BAO). We studied 141 patients with acute BAO enrolled in the Basilar Artery International Cooperation Study (BASICS) registry of whom baseline CT angiography (CTA) of the intracranial VAs was available. In 72 patients an additional CTA of the extracranial VAs was available. Adjusted risk ratios (aRRs) for death and poor outcome, defined as a modified Rankin Scale score a parts per thousand yen4, were calculated with Poisson regression in relation to VA occlusion, VA occlusion or stenosis a parts per thousand yen50 %, and bilateral VA occlusion. Sixty-six of 141 (47 %) patients had uni- or bilateral intracranial VA occlusion or stenosis a parts per thousand yen50 %. Of the 72 patients with intra- and extracranial CTA, 46 (64 %) had uni- or bilateral VA occlusion or stenosis a parts per thousand yen50 % and 9 (12 %) had bilateral VA occlusion. Overall, VA occlusion or stenosis a parts per thousand yen50 % was not associated with the risk of poor outcome. Patients with intra- and extracranial CTA and bilateral VA occlusion had a higher risk of poor outcome than patients without bilateral VA occlusion (aRR, 1.23; 95 % CI 1.02-1.50). The risk of death did not depend on the presence of unilateral or bilateral VA occlusion or stenosis a parts per thousand yen50 %. In conclusion, in patients with acute BAO, unilateral VA occlusion or stenosis a parts per thousand yen50 % is frequent, but not associated with an increased risk of poor outcome or death. Patients with BAO and bilateral VA occlusion have a slightly increased risk of poor outcome.