Leukoaraiosis and acute ischemic stroke: 90-day clinical outcome following endovascular recanalization, with proposed "L-ASPECTS"
Leukoaraiosis and acute ischemic stroke: 90-day clinical outcome following endovascular recanalization, with proposed "L-ASPECTS"
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DOI：
10.1136/neurintsurg-2020-015957
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发表时间：
2021-04-01
影响因子：
4.8
通讯作者：
Brinjikji, Waleed
中科院分区：
文献类型：
--
作者：
Benson, John;Seyedsaadat, Seyed Mohammad;Brinjikji, Waleed
BackgroundTo评估是否脑白质疏松的严重程度与急性缺血性卒中（AIS）患者的血管内血栓切除术后的结局相关，并提出一个脑白质疏松相关的修改ASPECTS score.MethodsA回顾性审查完成了AIS患者进行机械血栓切除术的前循环大血管闭塞。主要结果测量是90天mRS。通过从基于脑白质疏松严重性的传统ASPECT中减去（如果是轻度，则减去1分，如果是中度，则减去2分，如果是重度，则减去3分）来计算提出的脑白质疏松-ASPECTS（“L-ASPECTS”）。L-ASEPCTS评分性能通过75例AIS LVO患者的连续队列进行验证。结果174例患者纳入本回顾性分析：平均年龄：68.0 ± 9.1岁。无脑白质疏松28例（16.1%），轻度66例（37.9%），中度62例（35.6%），重度18例（10.3%）。在所有患者中，脑白质疏松症严重程度与90天mRS恶化相关（P=0.0005）。L-ASPECTS和ASPECTS均与不良结局相关，但L-ASPECTS的曲线下面积（AUC）较高（P
BackgroundTo assess if leukoaraiosis severity is associated with outcome in patients with acute ischemic stroke (AIS) following endovascular thrombectomy, and to propose a leukoaraiosis-related modification to the ASPECTS score.MethodsA retrospective review was completed of AIS patients that underwent mechanical thrombectomy for anterior circulation large vessel occlusion. The primary outcome measure was 90-day mRS. A proposed Leukoaraiosis-ASPECTS ("L-ASPECTS") was calculated by subtracting from the traditional ASPECT based on leukoaraiosis severity (1 point subtracted if mild, 2 if moderate, 3 if severe). L-ASEPCTS score performance was validated using a consecutive cohort of 75 AIS LVO patients.Results174 patients were included in this retrospective analysis: average age: 68.0 +/- 9.1. 28 (16.1%) had no leukoaraiosis, 66 (37.9%) had mild, 62 (35.6%) had moderate, and 18 (10.3%) had severe. Leukoaraiosis severity was associated with worse 90-day mRS among all patients (P=0.0005). Both L-ASPECTS and ASPECTS were associated with poor outcomes, but the area under the curve (AUC) was higher with L-ASPECTS (P