Analysis Of Prognostic Factors In Patients With Acute Vertebrobasilar Artery Occlusion Treated By Endovascular Therapy

Objective In this study,endovascular treatment was performed in patients with acute vertebrobasilar artery occlusion within 24 hours of symptom onset.The influencing factors related to good prognosis were analyzed,and the safety and efficacy of endovascular therapy were evaluated.Improve the clinical prognosis of patients and reduce the fatality rate.Method The patients with acute vertebrobasilar artery occlusion treated in Baotou Central Hospital from January 2012 to June 2019 were retrospectively included.All patients were confirmed as vertebrobasilar artery occlusion by multimode imaging and received endovascular treatment.According to the mRS score 90 days after treatment,the patients were divided into two groups:good prognosis group(0-3,40 cases)and poor prognosis group(4-6,27 cases).The baseline clinical data,imaging data and perioperative data of the two groups were analyzed.Both groups were treated with endovascular therapy,including mechanical thrombectomy,local catheter aspiration,balloon dilatation and stent implantation.90 days after treatment,the mRS scores of the patients were followed up by outpatient or telephone.The relationship between baseline data,clinical data and good prognosis was further evaluated.Results A total of 67 patients were enrolled in the group.The rate of good prognosis was 59.7%(40/67),and the successful recanalization rate was 89.6%(60/67).Univariate analysis revealed significant associations of the following parameters with favorable outcomes in the enrolled patients:age,sex,smoking status,baseline NIHSS score,baseline Glasgow coma scale(GCS)score,Pons-midbrain index(PMI),and intracranial atherosclerosis(ICAS).Multivariate logistic regression indicated that only age,baseline GCS score,and PMI were independently correlated with favorable outcomes at three months following EVT.Conclusions(1)Younger age,lower PMI,and higher GCS scores in patients with VBAO-induced AIS were associated with more favorable outcomes.(2)Endovascular treatment of acute vertebrobasilar artery occlusion in patients with high success rate of vascular recanalization,with high safety and effectiveness.