Analysis Of Risk Factors For Concurrent Large Area Cerebral Infarction In Patients With Good Reperfusion After Acute Ischemic Stroke With Large Vessel Occlusion

Objective: Acute ischemic stroke is a common disease in Chinese residents.Currently,intravenous AT-PA with endovascular device mechanical thrombectomy has an obvious benefit in patients with AIS-LVO.But there are still some patients with serious complications,a large area cerebral infarction.However,patients with large cerebral infarction significantly reduced our treatment effect and the survival prognosis of patients with good reperfusion.In this study,by analyzing the related factors of large area of cerebral infarction after AIS-LVO mechanical thrombectomy,to provide clinical basis for further improving the therapeutic effect,improve the survival benefit and improve the quality of life of patients.Methods: In this study,143 patients with mechanical thrombectomy,103 patients with good circulating reperfusion(72.03%,m TICI ≥ 2b)and poor circulating reperfusion 40 patients(27.97%,m TICI ≤ 2a)were collected to compare patient outcomes.With eliminated incomplete data and other complications,there were 85 patients in good circulating reperfusion,26 patients with large area cerebral infarction and 59 patients without large area cerebral infarction.Patient gender,age,smoking,hypertension,diabetes mellitus,coronary heart disease,atrial fibrillation,heart valve disease,past history of cerebral infarction,preoperative NIHSS score,preoperative m RS score,preoperative thrombolysis,thrombolysis,thrombolysis times,thrombotomy method,neutrophil percentage,D-dimer,plasma thrombin time(PT),international normalized ratio(INR),thrombin time(TT),fibrinogen(FIB),activated partial thromboplastin time(APTT),cholesterol,triglycerides,LDL,homocysteine,preoperative collateral circulation score,postoperative m TICI score and postoperative CT were collected.Using relevant statistical methods,factors associated with large cerebral infarction after AIS-LVO were obtained.Results:In univariate analysis,research finding statistically significant values p<0.05 for smoking,atrial fibrillation,preoperative use of thrombolytic drugs,collateral circulation score,neutrophil percentage,PT,INR,FIB,low density lipoprotein,and preoperative NIHSS score.Among them,except for LDL,which was negatively associated with concurrent large area cerebral infarction,all other factors were positively associated with concurrent large area cerebral infarction.Using logistics multivariate analysis,only large area cerebral infarction was found to be associated with the percentage of neutrophils(p=0.02 <0.05)and FIB change values(p=0.028 <0.028).Conclusions : Through retrospective analysis,we finding that AIS-LVO reperfusion with large area cerebral infarction may be closely associated with neutrophil percentage and FIB change value;AIS-LVO reperfusion with large area cerebral infarction may be associated with smoking,atrial fibrillation,preoperative thrombolysis,collateral circulation score,PT,INR,low-density lipoprotein and preoperative NIHSS score.