Nghiên cứu mối liên quan giữa hồi phục thần kinh với đặc điểm lâm sàng, hình ảnh cắt lớp vi tính và kết quả tái thông sau can thiệp lấy huyết khối bằng dụng cụ cơ học ở bệnh nhân đột quỵ thiếu máu não cấp do tắc động mạch thân nền

Abstract

Objective: The aim of this study was to investigate the relationship between outcome after recanalization by mechanical thrombectomy with clinical characteristics, computed tomography images and recanalization results in patients with acute basilar artery occlusion (ABAO). Subject and method: Retrospectively 49 patients with ABAO, treated with mechanical thrombectomy between November 2019 and May 2020 were identified. The relationship between functional outcomes and baseline characteristics, NIHSS and Glasgow scale on admission, pre-interventional pc-ASPECTS, the location of the clot, the present of a hyperdense basilar artery, as well as reocclusion and post-interventional symptomatic intracranial hemorrhage (sICH) were evaluated. Target variables were mRS at 90 days and mortality over 90 days. Result: Good outcome in 90-day after ABAO (mRS 0 - 2) was attained in 44.9% (n = 49) of patients, overall mortality was 34.7%. The efficacy predict outcome in 90-day after ABAO of MT within 24 hours of stroke onset were patients with atrial fibrillation [OR 0.197, 95% CI (0.003 - 0.95), p=0.016] Glasgow scale on admission lower 8 [0.125, 95% CI (0.02 - 0.64) p=0.01]. The NIHSS on admission lower 15 [4.40, 95% CI (1.22 - 15.84) p=0.032] and post-interventional imaging revealed sICH [2.7, 95% CI (1.65 - 4.41) p=0.015]. Risk for death was reduced by more than 90% if no post-interventional sICH present [0.053 95% CI (0.005 - 0.53) p=0.018]. Conclusion: MT in patients with ABAO within 24 hours of stroke onset had a high successful recanalization rate, overall mortality was 34.7%. Atrial fibrillation, low NIHSS and high Glasgow coma scale on admission, absence of post-intervention sICH were highly associated with favorable outcome.