Recurrent risk of ischemic stroke due to Vertebrobasilar Dolichoectasia
Recurrent risk of ischemic stroke due to Vertebrobasilar Dolichoectasia
复制标题
椎基底动脉延长扩张症导致缺血性中风复发的风险
DOI：
10.1186/s12883-019-1400-9
复制
发表时间：
2019-07-17
期刊：
影响因子：
2.6
通讯作者：
Xu, Gelin
中科院分区：
文献类型：
--
作者：
Chen, Zhaoyao;Zhang, Shuai;Xu, Gelin
背景椎基底动脉延长扩张症患者通常存在持续性血流动力学异常，因此中风的风险可能增加。本研究旨在确定椎基底动脉延长扩张症患者脑卒中复发的危险因素。方法对急性缺血性脑卒中患者进行筛查和资格评估。通过预定的临床访问或电话访谈对登记的患者进行随访。根据临床症状提出缺血性中风复发，并通过颅磁共振成像或计算机断层扫描证实。比较有和没有中风复发的患者的基线特征和血管几何形状。在COX比例风险模型中引入显着参数来检测脑卒中复发的可能预测因素。结果共纳入115例伴有椎基底动脉延长扩张的脑卒中患者，其中22例（19.1%）在随访22±6个月期间复发。基底动脉直径 ≥ 5.3 mm (HR = 4.744; 95% CI, 1.718–13.097;P= 0.003)，弥漫性颅内延长扩张(HR = 3.603; 95% CI, 1.718–13.097;P= 0.003) 1.367–9.496;P= 0.010)和缺血性心脏病史(HR = 4.095;95% CI,1.221–13.740;P =0.022)复发风险增加。结论脑卒中合并椎基底动脉延长扩张症患者复发风险较高。较大的基底动脉直径或弥漫性颅内延长扩张可能会增加复发的风险。
BackgroundPatients with vertebrobasilar dolichoectasia usually have persistent hemodynamic abnormalities, and therefore, may bear an increased risk of stroke. This study aimed to identify risk factors for stroke recurrence in patients with vertebrobasilar dolichoectasia.MethodsPatients with acute ischemic stroke were screened and evaluated for eligibility. Enrolled patients were followed via scheduled clinical visits or telephone interviews. Ischemic stroke recurrence was proposed with clinical symptoms and confirmed with cranial Magnetic Resonance Imaging or Computerized Tomography scans. Baseline characteristics and vascular geometry were compared between patients with and without stroke recurrence. Significant parameters were introduced into COX proportional hazard model to detect possible predictors of stroke recurrence.ResultsA total of 115 stroke patients with vertebrobasilar dolichoectasia were enrolled, of which 22 (19.1%) had recurrence during 22 ± 6 months follow-up. Basilar artery diameter ≥ 5.3 mm (HR = 4.744; 95% CI, 1.718–13.097;P= 0.003), diffuse intracranial dolichoectasia (HR = 3.603; 95% CI, 1.367–9.496;P= 0.010) and ischemic heart disease history (HR = 4.095; 95% CI, 1.221–13.740;P =0.022) had increased risk of recurrence.ConclusionsStroke patients with vertebrobasilar dolichoectasia may have a high risk of recurrence. Larger basilar artery diameter or diffuse intracranial dolichoectasia may increase the risk of recurrence.