关键词: 脑梗死, 大动脉闭塞, 支架取栓, 预后, 影响因素

Abstract: Objective  To investigate prognostic factors of mechanical thrombectomy in the treatment of patients with acute aortic occlusive cerebral infarction. Methods  A retrospective analysis was made on the prognosis of 50 patients with acute aortic occlusive cerebral infarction treated with mechanical thrombectomy. According to modified Rankin Scale Score (mRS) at 90 days postoperatively,  the patients were divided into two groups,  29 patients (mRS≤2) of good prognosis group  and 21 patients (mRS≥3) of poor prognosis group. Single factor contrast was carried out on the baseline data (underlying diseases,  age,  gender,  preoperative ASPECT score and preoperative NIHSS score),  treatment status (onset to revascularization time,  responsible occlusive artery,  collateral circulation,  number of thrombectomy,  methods of vascular recanalization) and treatment results (revascularization rate,  postoperative 24 h NIHSS score,  intracranial hemorrhagic transformation,  death),  and the variables with significant differences were further analyzed by multivariate logistic regression analysis in order to identify independent factors that influence patient prognosis. Results  There were significant differences in combined diabetes,  preoperative NIHSS score,  collateral circulation,  postoperative 24 h NIHSS score,  responsible occlusive artery,  revascularization rate,  and intracranial hemorrhagic transformation at one week postoperatively (all P<0.05). Multivariate Logistic regression analysis showed that there were statistically significant differences in collateral circulation,  revascularization rate,  hemorrhagic transformation at one week postoperatively and postoperative 24 h NIHSS score(all P<0.05). Conclusion  Diabetes,  preoperative NIHSS score,  collateral circulation,  responsible occlusive artery,  postoperative 24 h NIHSS score,  revascularization rate,  and intracranial hemorrhagic transformation at one week postoperatively are the factors affecting the prognosis of patients. Good compensation of collateral circulation,  high revascularization rate,  high intracranial hemorrhagic transformation at one week postoperatively and deterioration in postoperative 24 h NIHSS score are independent factors affecting the prognosis of patients.

Key words: brain infarction, aortic occlusion, mechanical thrombectomy, prognosis, influencing factors