Influential Factors Of Prognosis Of Endovascular Treatment In Patients With Acute Anterior Circulation Vascular Occlusion

Objective: To study some related factors that affect the prognosis of endovascular interventional therapy in patients with acute precirculation vascular occlusion,and provide clinical research basis for preoperative risk assessment,assisting in formulating treatment plans and improving prognosis.Methods:A total of 61 patients with acute precirculatory vascular occlusion who underwent endovascular intervention were selected from the stroke center of Hunan Provincial People's Hospital from January2018 to October 2019.The clinical data of the patients were collected,including gender,age,smoking history and alcoholism History,NIHSS score,ESSEN score,ASPECTS score,whether to take a thrombus,whether there is a history of cerebral infarction and/or cerebral hemorrhage,hypertension,diabetes,atrial fibrillation,dyslipidemia,etc.Surgery method,time from onset to treatment(OTT time),vascular recanalization status;whether there is high-density exudation of cranial CT immediately after surgery,symptomatic intracranial hemorrhage after surgery,mRS at hospital or telephone follow-up at three months Ratings and other information.The patients were divided into two groups according to the mRS score at three months: Good prognosis group(mRS score ranged from 0 to 2 points),a total of 29 cases;Poor prognosis group(mRS score ranged from 3 to 6 points),a total of 32 cases.The basic data of the two groups were compared.Univariate analysis and Logistic multivariate regression analysis were used to analyze the influence of each factor on the prognosis.Results:1.There were no statistically significant difference in gender,age,history of diabetes,history of stroke,history of atrial fibrillation,history of smoking,history of alcohol abuse,history of responsible blood vessels,bridging therapy and surgical methods between the two groups with good prognosis and those with poor prognosis(P> 0.05).2.The proportion of patients with ACG ? grade 2 of collateral circulation and OTT time <6 hours in the group with good prognosis was significantly higher than that in the group with poor prognosis,and the difference was statistically significant(P<0.001).The proportion of patients with high density CT exudation immediately after surgery in the group with good prognosis was lower than that in the group with poor prognosis,and the difference was statistically significant(P<0.05).3.The proportion of hypertension in the group with poor prognosis was higher than that in the group with good prognosis,and the difference was statistically significant(P<0.05).The baseline NIHSS and baseline ESSEN scores in the group with poor prognosis were significantly higher than those in the group with good prognosis,and the difference was statistically significant(P<0.001).4.Logistic regression analysis showed that the ACG classification of collateral circulation had a significant negative influence(p<0.05),with the OR value of 0.148,indicating that the lower the ACG classification of collateral circulation was,the higher the risk of poor prognosis was.History of hypertension,OTT time,and baseline NIHSS score showed significant positive effects(P<0.01),indicating that patients with a history of hypertension had an increased risk of poor prognosis.The longer OTT time was,the higher baseline NIHSS score was,and the higher the risk of poor prognosis was.Immediate CT high density exudation ratio and baseline ESSEN score were not included in theregression equation(P>0.05).Conclusion:1.The history of hypertension,ACG classification,OTT time,high density exusive CT immediately after surgery,baseline NIHSS score and ESSEN score were the main factors affecting the prognosis of patients.2.History of hypertension,ACG classification,OTT time,and baseline NIHSS score were independent factors affecting patient prognosis.