Analysis Of Prognostic Factors Of Mechanical Thrombectomy For Acute Ischemic Stroke With Posterior Circulation Large Vessel Occlusion

Objective: The aim of this research was to see how mechanical thrombectomy affected prognosis in acute posterior circulation ischemic stroke.Methods: Mechanical thrombectomy and DSA tests were performed in 57 patients with acute cerebral infarction at the Fourth China Medical University hospital between August 2016 and November 2020.The adjusted Rankin Scale(MRS)score is used to classify patients into two groups 90 days after surgery: those with a positive prognosis(mRs score ≤ 2)and those with a negative prognosis(mRs score > 3).Both groups’ clinical data are compared,and the factor that determines prognosis is investigated.F-stroke software was used to assess the volume of the core infarct and the clinical diffusion mismatch(CDM).The patients with CDM were examined and analyzed to see whether mechanical thrombectomy was effective.result:1.There have been 28 cases in the positive prognosis group and 29 cases in the negative prognosis group of the 57 patients.The percentage of positive prognosis was49.1%.The overall recanalization rate was 87.7%(50/57),with a mortality rate of19.3 %(11/57).2.Patients with a positive prognosis had less core infarction than those with a negative prognosis(P＜0.05).The stent salvage care ratio was significantly higher in the positive prognosis group than in the negative prognosis group,and the difference was statistically significant(P＜0.05).A protective factor for a positive prognosis was a small infarct core volume(95% CI: 1.001-1.237,or: 1.113,P = 0.048).3.As per the clinical-diffusion mismatch(CDM)criteria proposed in this thesis,31 patients with CDM had a recanalization rate of 90.3 % after mechanical thrombectomy;15 patients had a strong prognosis(mRs score 0-2),accounting for48.4 %;8 patients had an average prognosis(mRs score 3-4),accounting for25.8%;and 8 patients had a bad prognosis(mRs score 5-6),accounting for 25.8%.There were 2 patients without CDM and all died.Conclusion:1.Small core infarct volume and remedial stent therapy will encourage a positive prognosis 90 days after procedure in patients with posterior circulation acute large vessel occlusion ischemic stroke,and tiny infarct core volume is a protective factor for a positive prognosis.2.Acute ischemic stroke patients with posterior circulation and clinical-diffusion mismatch benefit from mechanical thrombectomy.Mechanical thrombectomy can have a lower benefit value in patients who are in a coma and have a greater infarct core volume.