CTA源影像的后循环ASPECT评分对急性椎-基底动脉闭塞性缺血性卒中患者Solitaire AB支架取栓术预后的预测价值

摘要

Objective To evaluate the value of the CT angiography source image posterior circulation acute stroke prognosis early CT(CTA-SI pc-ASPECT) score in predicting the prognostic value of acute stroke patients with acute verte-brobasilar occlusion treated by thrombectomy using solitaire AB stent .Methods Between November 2014 to March 2017 , a total of 19 acute ischemic stroke patients with vertebrobasilar occlusion who were treated by thrombectomy using Solitaire AB stent.All the patients accepted assessment of NIHSS score and CTA-SI pc-ASPECT score before undergoing endovascu-lar treatment.The the modified Rankin Scale(mRS) scores of each patient was recorded at 3 months after onset.The pa-tients with mRS ≤2 were divided into a good prognosis group ,The patients with mTICI level ≥2b were divided into favora-bly rechanneled group .Focused on the assessment of relationship between CTA-SI pc-ASPECT score and prognosis of the patients.The other predictive factors for clinical outcomes were also studied .Results Mechanical thrombectomy with Soli-taire stent was performed in19 patients.A good prognosiswas observed in 12 patients.Successful recanalizationwas obtained in 12 patients.Five patients had symptomatic intracranial hemorrhage .Good prognosis and symptomatic intracranial hemor-rhage between patients with CTA-SI pc-ASPECT score>8 group and CTA-SI pc-ASPECT score≤8 group were significantly different.Conclusion Mechanical thrombectomy with the Solitaire AB stent in acute ischemic stroke patients with acute vertebrobasilar occlusion is relatively safe and effective .The CTA-SI pc-ASPECT score are the prognostic risk factor for the acute ischemic stroke patients with acute vertebrobasilar occlusion treated by thrombectomy using solitaire AB stent .%目的 探讨CTA源影像的后循环ASPECT(CTA-SI pc-ASPECT)评分对急性椎-基底动脉闭塞性缺血性卒中患者Solitaire AB支架取栓术预后的预测价值.方法 回顾性分析我科在2014年11月～2017年3月行血管内治疗急性椎-基底动脉闭塞性缺血性卒中患者19例,治疗前行NIHSS评分、CTA-SI pc-ASPECT评分,3 m后行mRS评分,定义mRS≤2分为预后良好,mRS>2分为预后不良,改良脑梗死溶栓试验分级(mTICI)≥Ⅱb为血管再通.研究CTA-SI pc-ASPECT评分及其他可能影响临床预后的因素.结果 共19例患者行机械取栓术,12例患者预后良好,症状性脑出血患者5例,5例患者死亡,血管成功再通12例.CTA-SI pc-ASPECT评分>8分与≤8分组在预后良好及症状性颅内出血率差异有统计学意义.结论 在急性椎-基底动脉闭塞性缺血性卒中患者中使用Solitaire支架取栓是相对安全有效的,CTA-SI pc-ASPECT评分≤8分发生不良预后及症状性颅内出血率风险较大.