Nghiên cứu mối liên quan giữa điểm ASPECTS, mức độ tuần hoàn bàng hệ mạch não với kết quả điều trị bằng dụng cụ cơ học bệnh nhân đột quỵ thiếu máu não cấp do tắc nhánh lớn vòng tuần hoàn não trước

Abstract

Objective: To assess the relationship between the ASPECTS (Alberta Stroke Program Early Computed Tomography Score) by computerized tomography (CT), the collateral flow scores (CFS) by CT angiography (CTA), by digital subtraction angiography (DSA) and clinical outcome in patients with anterior circulation acute ischemic stroke, who had treated mechanical thrombectomy. Subject and method: 103 consecutive patients with acute occlusion of the middle cerebral artery (MCA) or internal carotid artery (ICA) were reviewed retrospectively at 108 Military Central Hospital from July 2016 to December 2017. Evaluation of ASPECTS and CFS by CTA, DSA. Determinated of clinical outcome in patients with anterior circulation acute ischemic stroke, who had treated mechanical thrombectomy by modified Rankin Score (mRS). Assessment the relationship between clinical outcome and ASPECTS and CFS. Result: Average age: 64.67 ± 12.63, from 32 - 84. 44 patients (42.7%) ICA occlusion, 59 patients (57.4%) MCA occlusion. ASPECTS average was 7.88 ± 1.76, ASPECTS < 7 was 21.4%, ASPECTS ³ 7 had 78.6%. CFS by CTA had 3 levels: Good (9.7%), average (39.8%), poor (50.5%). CFS by DSA were included good (20.7%), average (41.3%), poor (38%). Modified Rankin Scale (mRS) after 3 months: Good (mRS 0 - 2): 62.1%, death (mRS 6): 15.5%. Patients with ASPECTS below 7 had a mortality higher than who had ASPECTS ³ 7 (p<0.05). The level good of CFS by CTA was associated with good improved neurological function after 3 months and fultile revasculation (p<0.05). Conclusion: Low ASPECTS was associated with high mortality, CFS levels by CTA were associated with good improved neurological function after 3 months and fultile revasculation.