Lenticulostriate arteries appearance before thrombectomy predicts good outcome in acute middle cerebral artery occlusion

BMC Neurology

Hao Shen¹  Gang Li¹  Mengruo Guo¹  Ying Li¹  Feifeng Liu¹  Yaping Xiao¹  Xinyi Yang¹  Chen Chen¹  Wenjie Cao²  Qiang Dong²  Lan Hong²  Xin Cheng² 

[1] Department of Neurology, Shanghai East Hospital, Tongji University;Department of Neurology, Shanghai huashan hospital, Fudan University;

关键词: Middle cerebral artery occlusion;    Lenticulostriate artery;    Thrombectomy;    Outcome;    Ischemic stroke;   

DOI  :  10.1186/s12883-020-01716-1

来源: DOAJ

【 摘 要 】

Abstract Background Endovascular therapy is widely used in acute large vessel occlusion. This study investigated whether imaging of lateral lenticulostriate arteries (LSAs) before thrombectomy would potentially be helpful for predicting prognosis of patients with acute M1 segment of middle cerebral artery occlusion (MCAO). Methods 59 consecutive patients with acute M1 segment of MCAO treated with mechanical thrombectomy at two comprehensive stroke centers were analyzed. Patients were categorized into LSA+ (appearing of lateral LSAs) and LSA- (sparing of lateral LSAs) group according to preprocedural digital substraction angiography (DSA). Baseline data and clinical outcomes were compared. A good clinical outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The association between clinical and imaging parameters and functional outcome was evaluated with logistic regression analysis. Results LSA+ was shown in 36 patients (61%). LSA+ group had a significantly higher proportion of good outcome (72.2% vs. 8.7%, OR 27.3,95% CI 5.38–138.4, P < 0.001), lower risk of symptomatic intracranial haemorrhages (sICH) (8.3% vs. 47.8%,OR 0.10,95% CI 0.02–0.42, P = 0.001) and lower mortality in hospital (5.6% vs. 34.8%, OR 0.11,95% CI 0.02–0.58, P < 0.004) compared with LSA- group. Patients in LSA+ group had lower baseline NIHSS score(P < 0.01) and NIHSS score at 14 days(P < 0.01) and smaller infarct core volume (P = 0.016) on computed tomography perfusion imaging (CTP) compared to the LSA- group. Multivariate logistic regression analysis showed that a small infarct core volume (OR 6.74,95% CI 1.148–39.569, P = 0.035) and LSA+(OR 22.114,95% CI 3.339–146.470, P = 0.001) were associated with a good clinical outcome. Conclusions Our data suggest that appearance of lateral LSAs before mechanical thrombectomy would be potentially helpful for predicting favorable prognosis of patients with acute M1 segment of MCAO.

【 授权许可】

Unknown