Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study
Abstract Background The optimal treatment for cerebral infarction caused by posterior circulation occlusion of large vessels has not yet been determined. Intravascular interventional therapy is an important treatment for cerebral infarction with posterior circulation occlusion of large vessels. Howe...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
|
| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12883-023-03166-x |
| _version_ | 1797853716773076992 |
|---|---|
| author | Ying Xie Xi Liu Hongli Gu Guanghong Zhong Yangchun Wen Jinzhao He Xiaojin Zhong |
| author_facet | Ying Xie Xi Liu Hongli Gu Guanghong Zhong Yangchun Wen Jinzhao He Xiaojin Zhong |
| author_sort | Ying Xie |
| collection | DOAJ |
| description | Abstract Background The optimal treatment for cerebral infarction caused by posterior circulation occlusion of large vessels has not yet been determined. Intravascular interventional therapy is an important treatment for cerebral infarction with posterior circulation occlusion of large vessels. However, endovascular therapy (EVT) of some posterior circulation cerebrovascular is ineffective and eventually become futile recanalization. Therefore, we performed a retrospective study to explore the factors influencing futile recanalization after EVT in patients with posterior circulation large-vessel occlusion. Methods Eighty-six patients with acute cerebral infarction and posterior circulation large vessel occlusion after intravascular intervention were divided into two groups according to their modified Rankin scale (mRS) scores after 3 months: group 1, mRS scores less than or equal to 3 (the effective recanalization group); group 2, mRS scores greater than 3 (the ineffective recanalization group). The basic clinical data, imaging index scores, time from onset to recanalization, and operation time between the two groups were compared and analyzed. Logistic regression was used to analyze the factors influencing indicators of good prognosis, and the ROC curve and Youden index were used to determine the best cutoff value. Results Between the two groups, there were significant differences in the posterior circulation CT angiography (pc-CTA) scores, GCS scores, pontine midbrain index scores, time from discovery to recanalization, operation time, NIHSS score and incidence of gastrointestinal bleeding. The logistic regression revealed that the NIHSS score and time from discovery to recanalization were associated with good prognoses. Conclusion NIHSS score and recanalization time were independent influencing factors of ineffective recanalization of cerebral infarctions caused by posterior circulation occlusion. EVT is relatively effective for cerebral infarction caused by posterior circulation occlusion when the NIHSS score is less than or equal to 16 and the time from onset to recanalization is less than or equal to 570 min. |
| first_indexed | 2024-04-09T19:55:13Z |
| format | Article |
| id | doaj.art-5a540da2c5a248f2a9c4c6a181ae61f2 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-04-09T19:55:13Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-5a540da2c5a248f2a9c4c6a181ae61f22023-04-03T05:31:15ZengBMCBMC Neurology1471-23772023-03-012311910.1186/s12883-023-03166-xInfluencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective studyYing Xie0Xi Liu1Hongli Gu2Guanghong Zhong3Yangchun Wen4Jinzhao He5Xiaojin Zhong6Department of Neurology, Heyuan People’s HospitalDepartment of Neurology, Heyuan People’s HospitalDepartment of Neurology, Heyuan People’s HospitalDepartment of Neurology, Heyuan People’s HospitalDepartment of Neurology, Heyuan People’s HospitalDepartment of Neurology, Heyuan People’s HospitalDepartment of Neurology, Heyuan People’s HospitalAbstract Background The optimal treatment for cerebral infarction caused by posterior circulation occlusion of large vessels has not yet been determined. Intravascular interventional therapy is an important treatment for cerebral infarction with posterior circulation occlusion of large vessels. However, endovascular therapy (EVT) of some posterior circulation cerebrovascular is ineffective and eventually become futile recanalization. Therefore, we performed a retrospective study to explore the factors influencing futile recanalization after EVT in patients with posterior circulation large-vessel occlusion. Methods Eighty-six patients with acute cerebral infarction and posterior circulation large vessel occlusion after intravascular intervention were divided into two groups according to their modified Rankin scale (mRS) scores after 3 months: group 1, mRS scores less than or equal to 3 (the effective recanalization group); group 2, mRS scores greater than 3 (the ineffective recanalization group). The basic clinical data, imaging index scores, time from onset to recanalization, and operation time between the two groups were compared and analyzed. Logistic regression was used to analyze the factors influencing indicators of good prognosis, and the ROC curve and Youden index were used to determine the best cutoff value. Results Between the two groups, there were significant differences in the posterior circulation CT angiography (pc-CTA) scores, GCS scores, pontine midbrain index scores, time from discovery to recanalization, operation time, NIHSS score and incidence of gastrointestinal bleeding. The logistic regression revealed that the NIHSS score and time from discovery to recanalization were associated with good prognoses. Conclusion NIHSS score and recanalization time were independent influencing factors of ineffective recanalization of cerebral infarctions caused by posterior circulation occlusion. EVT is relatively effective for cerebral infarction caused by posterior circulation occlusion when the NIHSS score is less than or equal to 16 and the time from onset to recanalization is less than or equal to 570 min.https://doi.org/10.1186/s12883-023-03166-xCerebral infarctionEndovascular therapyFutile recanalizationPosterior circulation occlusion |
| spellingShingle | Ying Xie Xi Liu Hongli Gu Guanghong Zhong Yangchun Wen Jinzhao He Xiaojin Zhong Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study BMC Neurology Cerebral infarction Endovascular therapy Futile recanalization Posterior circulation occlusion |
| title | Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study |
| title_full | Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study |
| title_fullStr | Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study |
| title_full_unstemmed | Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study |
| title_short | Influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels: a retrospective study |
| title_sort | influencing factors of futile recanalization after endovascular therapy for cerebral infarction with posterior circulation occlusion of large vessels a retrospective study |
| topic | Cerebral infarction Endovascular therapy Futile recanalization Posterior circulation occlusion |
| url | https://doi.org/10.1186/s12883-023-03166-x |
| work_keys_str_mv | AT yingxie influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy AT xiliu influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy AT hongligu influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy AT guanghongzhong influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy AT yangchunwen influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy AT jinzhaohe influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy AT xiaojinzhong influencingfactorsoffutilerecanalizationafterendovasculartherapyforcerebralinfarctionwithposteriorcirculationocclusionoflargevesselsaretrospectivestudy |