| Object: There are few studies on acute posterior circulatory stroke compared with those on anterior circulatory stroke,The etiology of posterior circulation stroke is as diverse as that of anterior circulation,and individualized EVT strategies can be formulated according to different etiologies.However,the prognosis of patients after EVT is still poorly studied,and the degree of benefit after treatment remains unclear.In this study,the clinical data of patients with acute posterior circulation stroke were collected to compare and analyze the baseline clinical characteristics,safety and efficacy differences of aortic atherosclerotic(LAA)and cardiogenic(CE)stroke.At the same time,the related risk factors affecting the prognosis of EVT in the two types of acute posterior circulation stroke were analyzed.Methods: We collected a total of 123 patients with posterior circulatory stroke who were admitted to the hospital from January 1,2017 to December 31,2020,who met the inclusion criteria and performed EVT(including 97 patients with LAA etiology and 26 patients with CE).According to the patient’s demographic characteristics,current medical history,past medical history,laboratory examinations and other baseline data,compare the differences in baseline data of the two component types of diseases;during endovascular treatment,we choose to compare and analyze the collateral compensation capabilities of the two(SIR),the location of the responsible vessel for occlusion,recanalization after thrombus removal(m TICI),and whether to apply salvage treatment strategies(angioplasty,stent placement),etc.;the neurological function score(90d-m RS)at three months after surgery is evaluated the main indicators of patient prognosis;the comparison of the safety of thrombus removal between the two is mainly used to analyze and evaluate the incidence of intracranial hemorrhage conversion,the reocclusion rate of responsible vessels,and the 90-day stroke-related mortality.Finally,the study of independent risk factors for poor prognosis of the two types of etiology by EVT used multivariate logistic regression statistical analysis.Results: When we compared the clinical data of LAA and CE,LAA stroke patients are younger(60.76±12.88 versus 72.54±10.22,p=0.001),there were more male patients(78.4% versus 57.7%,p=0.033),have a higher prevalence of hyperlipidemia(55.7% versus 23.1%,p=0.003),and preoperative systolic blood pressure Higher(149.25±21.24 versus 134.79±22.83,p=0.010),lower NIHSS score(17.3 versus 22.2,p=0.040),better collateral circulation(SIR 2-4 ratio,61.9% versus 19.2%,p=0.002),the angioplasty rate is higher(32.0% versus 3.8%,p=0.002).However,the EVT recanalization rate(m TICI score of 2b-3,86.6%versus 84.6%,p=0.756)of the two groups of patients,Prognosis than 90d-m RS(0-2)(59.8% versus 42.3%,p=0.111),The incidence of postoperative intracranial hemorrhage transformation(2.1% versus 0%,p=1.000)and the 90-day stroke-related mortality(19.6% versus 34.6%,p=0.105)were not statistically significant.Multivariate logistic regression analysis indicated that Age,GLU,SIR,WBC count within 24 h,and m TICI were independent risk factors for the poor prognosis of EVT in the LAA group.However,due to the small sample size of CE group,it is difficult to ensure the validity of multiple logistic regression analysis.Conclusions: There was no significant difference in prognosis between LAA and CE post-cycle acute stroke,although there were differences in baseline clinical data and EVT clinical features.According to data,there are differences in independent risk factors affecting the prognosis of the subjects in the above two groups.In clinical work,identifying their risk factors and formulating specific treatment regimens according to different causes of post-circulation stroke may improve the prognosis of patients. |
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