Analysis Of Influencing Factors Of Solitaire AB Stent In The Treatment Of Acute Posterior Circulation Macrovascular Occlusion

Objective:To investigate the factors influencing the prognosis of cerebral infarction caused by acute posterior circulation vascular occlusion and treated with mechanical thrombectomy based on the Solitaire AB stent.Methods:A total of 83 patients with acute cerebral infarction caused by posterior circulating large vascular occlusion and treated with Solitaire AB stent in our hospital between January 2015 ~ December 2017.Patients having good outcome were defined as the score 0~2 after 3 months with mRS,and the poor outcome were defined as the score 3~6.We analyzed the baseline data(gender,age,the National Institutes of Health Stroke Scale(NIHSS)at admission,the Alberta stroke program early CT score(ASPECTS)at admission,the related underlying diseases and collateral compensatory conditions)and the clinical data(recanalization status,anesthesia,onset to puncture time,operation time,onset to recanalization time),and then the multiple factors Logistic regression was used to identify the prognostic factors.Results:1.73 patients were successfully repassed(87.9%),31 patients had a good prognosis(37.3%)at 90-day,9 patients died(10.8%),and there were significant differences between the two groups including the age,sex,admission NIHSS score and ASPECT,and the proportion of patients with hypertension,diabetes,and collateral compensatory good(Grading 3-4)(all P<0.05),the rest of baseline data were no significant differences(all P>0.05).2.the proportion of successful recanalization rate in two groups of clinical data was slightly higher than that of poor prognosis group [90%(28/31)vs 87%(45/52)],Two groups' onset to puncture time [360(330-408)vs 396(336-472)min]and onset to recanalization time [406(330-430)min vs 540(437-603)min](437-603)min] have significant differences(all P<0.05).3.Multiple factors Logistic regression analysis showed that the higher NIHSS score(OR=1.370,95% CI: 1.044-1.797),longer onset to successful recanalization time(OR=1.016,95% CI: 1.001-1.032),and diabetes(OR=10.207,95% CI: 1.051-95.664)were risk factors for poor prognosis(al P<0.05),but the higher ASPECTS(OR=0.203,95% CI: 0.061-0.671)and the good collateral compensation(Grading 3-4)(OR=0.008,95% CI: 0.001-0.861)are good prognostic factors(all P<0.05).Conclusion:Admission of ASPECTS and collateral are protective factors affecting the prognosis of Solitaire AB stent in the treatment of acute posterior circulation macrovascular occlusion,and the higher the admission ASPECTS is,the better the prognosis.The admission of NIHSS score,the onset of the successful recanalization time,and the combination of diabetes are the risk factors for poor prognosis of Solitaire AB stent in the treatment of acute posterior circulation large vessels,and the higher the admission NIHSS score,the longer the successful onset time,the worse the prognosis...