Clinical Study On The Contrast Staining Of Brain Tissue After Mechanical Thrombectomy In Acute Ischemic Stroke

Objective:To understand the rate of contrast staining of brain tissue after mechanical thrombectomy in acute ischemic stroke.To find the influence factors of contrast staining of brain tissue,and the relationship between contrast staining and symptomatic hemorrhage,and the influence factors of good long-term prognosis.Methods:From January 2016 to October 2017,a total of 45 patients who had large vessel occlusion in the department of neurology of the Hebei general hospital received mechanical thrombectomy.Basic information,the situation before onset and operation situation were recorded,NIHSS score and the head CT scan ware assessed postoperative immediately,ASPECT score was assessed to reflect the size of contrast staining brain tissue,the DWI scans were completed within 7 days.After 90 days,to follow-up those patients,to assess the mRS score.Use SPSS 21.0 to analyze data,continuous variables using mean ± standard deviation,we use the t test to compare the differences between the two groups of patients,and percentage(%)for categorical variables,use chi-square test to compare the differences between groups,single factor and multiple factors logistic regression were used to explore the main influence factors of brain tissue contrast staining and long-term prognosis,Results:1.Among the 45 patients,24 were stained with contrast agent,accounting for 53%,and 6 patients with symptomatic intracranial hemorrhage,accounting for 13.3%,and 21 with good prognosis in 90 days,accounting for 47%.2.The age,preoperative NIHSS score,and the number of thrombectomy and occlusion site were statistically significant between contrast staininggroup and none contrast staining group(P<0.05).There was a statistically significant difference between the two groups in symptomatic hemorrhage(P<0.05).3.Logistic regression analysis showed that the preoperative NIHSS score(OR=1.499)increased by one point,and the incidence of brain tissue contrast staining was increased by 49.9%.When the number of thrombectomy(OR=4.008)increased by one point,the probability of contrast agent staining increased by 300%.4.Logistic regression analysis showed that the NIHSS score postoperative and the number of thrombectomy were the main factors affecting the long-term prognosis of patients.Postoperative NIHSS score(OR=0.664)increased by one point,and the incidence of good long-term prognosis was decreased by 33.6%.the number of thrombectomy(OR=0.266)increased by one point,the probability of good long-term prognosis was decreased by73.4%.Conclusions:1.The preoperative NIHSS score and the number of thrombectomy were the main factors affecting the contrast staining after the thrombectomy of the patients with acute anterior circulation occlusion.The number of preoperative NIHSS score or thrombectomy increased by one and the probability of contrast staining was increased by 49.9% and 300%,respectively.2.The main factors that affect the long-term prognosis of patients with acute anterior circulation of large vessel occlusion are the number of thrombectomy and postoperative NIHSS score;the number of thrombectomy or postoperative NIHSS score increased by one and the probability of long-term prognosis was reduced by 73.4% and 33.6%,respectively.3.The risk of intracranial hemorrhage was indicated by the contrast staining of brain tissue,but it did not indicate the long-term prognosis of patients.