Leukoaraiosis severity and outcomes after mechanical thrombectomy with stent-retriever devices in acute ischemic stroke
Leukoaraiosis severity and outcomes after mechanical thrombectomy with stent-retriever devices in acute ischemic stroke
复制标题
急性缺血性脑卒中使用支架回收装置进行机械血栓切除术后脑白质疏松的严重程度和结果
DOI：
10.1136/neurintsurg-2018-014018
复制
发表时间：
2019-02-01
影响因子：
4.8
通讯作者：
Liu, Xinfeng
中科院分区：
文献类型：
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作者：
Guo, Yongtao;Zi, Wenjie;Liu, Xinfeng
背景和目的该研究的目的是评估脑白质疏松症的严重程度是否与接受支架取栓装置机械血栓切除术的急性中风患者的结局相关。方法在这项回顾性多中心研究中，我们评价了251例接受支架取栓装置治疗的急性卒中患者（治疗前美国国立卫生研究院卒中量表评分≥8）。根据货车Swieten量表，脑白质疏松严重程度分为0-2级（无至中度）和3-4级（重度）。主要临床结局是良好功能结局的比例，定义为90天时改良兰金量表0-2分。结果重度LA组功能恢复良好的患者明显少于无中度LA组（18.4% vs50.2%，P<0.001）。在多变量分析中，重度脑白质疏松症是90天时良好功能结局的显著负性预测因子（OR，0.27; 95%CI 0.10-0.77; P=0.014）。结论：脑白质疏松的严重程度与接受支架取栓装置机械血栓切除术的急性卒中患者的90天功能结局独立相关。
Background and purpose The aim of the study was to evaluate whether leukoaraiosis severity is associated with outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices. Methods In this retrospective multicenter study, we evaluated 251 acute stroke patients (pretreatment National Institutes of Health Stroke Scale score ≥8) treated with stent-retriever devices. Leukoaraiosis severity was graded as 0–2 (absent-to-moderate) versus 3–4 (severe) according to the van Swieten scale. The main clinical outcome was the proportion of good functional outcome, defined as a modified Rankin Scale of 0–2 at 90 days. Results Significantly fewer patients in the severe LA group than in the absent-to-moderate LA group achieved a good functional outcome (18.4% vs 50.2%, P<0.001). In multivariable analysis, severe leukoaraiosis was a significant negative predictor of good functional outcome at 90 days (OR, 0.27; 95% CI 0.10–0.77; P=0.014). Conclusions The severity of leukoaraiosis is independently associated with 90-day functional outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.