| Objective: The purpose of this study is to explore the collateral circulation in mechanical thrombectomy for acute ischemic stroke.Methods: There were 115 patients of thrombectomy for acute ischemic stroke from January 2015 to November 2019 December,who received Solitaire stent thrombolysis in the department of neurology stroke center of our hospital.Collect their clinical data.Patients were divided into two groups according to collateral circulation scoring system :the grade of collateral circulation less than 2 was defined as the adverse collateral circulation group;the grade of collateral circulation greater than 2 was defined as the good collateral circulation group,Patients were divided into two groups according to m RS score after 90 days of thrombolysis :m RS 0~2 was divided into good outcome group,and 3~6 was bad outcome group.T test or non-parametric test was applied to measurement data,and chi-square test was applied to count data,and binary logistic regression analysis was performed to further analyze the independent influence of collateral circulation prognosis and the correlation of short-term prognosis of thrombectomy.Results: 1.The group with good collateral circulation group had 56,and the group with adverse collateral circulation group had 59,baseline information of the patients,the cerebrovascular history,hypertension,diabetes,coronary heart disease,smoking history,drinking history,atrial fibrillation and other risk factors were 26 cases,24cases,32 cases,35cases,9cases,35 cases,20cases,17 cases,21cases,34 cases,23cases,17 cases,16cases,19 cases,respectively.Among them,there were 82 males with age ± mean standard deviation were 64.61±10.66?65.98±11.36.The median and quartile of diastolic and systolic blood pressure are respectively were 90(80-100)?80(72-93)?152(130-170)150(140-179).The biochemical indexes of glycated hemoglobin and homocysteine were respectively5.6(5.4-5.9)?6.1(5.4-7.1)?14(11.85-17.78)16.2(12.5-20).The history of diastolic blood pressure(P=0.006)the history of diabetes(P=0.00)and the smoking history(P=0.031)in the two groups showed statistical difference.The diastolic blood pressure and the history of diabetes were tested with binary Logistic regression analysis.The results showed that history of diabetes((OR=1.033 95%CI:1.033-1.063P=0.031))and the diastolic blood pressure(OR=0.140 95%CI:0.057-0.347 P=0.00)were independent predictive factors of collateral circulation formed.2.The group with good prognosis had 59 patients,the group with bad prognosis had 56 patients.the group with good collateral circulation had better short-term prognosis than the group with poor collateral circulation.P=0.001,(P<0.05)two groups showed statistical difference.The secondary collateral opening had a better short-term prognosis than primary opening.p=0.011,(P<0.05)two groups showed statistical difference.The single collateral circulation group was compared with the two-stage collateral circulation group,the two-stage collateral circulation group had a better short-term prognosis than the singlestage collateral circulation group.P=0.00(P<0.05)two groups showed statistical difference.3.There was no significant difference in the opening degree of collateral circulation at different sites of vascular lesions.The short-term prognosis of the patients with the lesions of the responsible vessels located in the anterior circulation is better than that of the patients with the lesions of the responsible vessels located in the posterior circulation(P=0.004).(P<0.05)and a statistically significant differences.Conclusion: 1.Diastolic blood pressure and history of diabetes are the predictive factors in the formed of collateral circulation.2.Patients with good collateral circulation have a better short-term prognosis.The evaluation of collateral can predict the short-term prognosis of thrombectomy.3.Patients with responsible vascular lesions located in the anterior circulation had a better short-term prognosis. |
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