ABSTRACT
Objective:To investigate the predictors of outcome after endovascular therapy in patients with acute basilar artery occlusion (ABAO).Methods:Patients with ABAO received EVT in Bozhou People’s Hospital from May 2019 to September 2022 were included prospectively. The demographic data, clinical data, relevant parameters of periprocedural period and follow-up data were collected. The outcome evaluation was performed at 90 d after procedure. The modified Rankin Scale score ≤3 was defined as good outcome, and >3 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of good outcome after EVT. Results:A total of 42 patients with ABAO were included, 21 (50%) had a good outcome and 21 had a poor outcome. There were significant differences in the National Institutes of Health Stroke Scale (NIHSS), posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), the time from onset to recanalization, the proportion of patients with successful recanalization, use of remedial treatment, and complications were statistically significant in both groups (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for other risk factors, the low NIHSS score (odds ratio [ OR] 0.756, 95% confidence interval [ CI] 0.615-0.903; P=0.008), less use of remedial treatment measures ( OR 0.170, 95% CI 0.033-0.884; P=0.035) and high pc-ASPECTS ( OR 4.274, 95% CI 1.418-12.882; P=0.010) were the independent predictors of good outcomes. Conclusions:Half of the patients with ABAO have a good outcome after EVT. Low NIHSS score, high pc-ASPECTS at admission and less use of remedial measures are the independent predictors of good outcomes in patients with ABAO.
ABSTRACT
Objective:To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with severe carotid artery stenosis.Methods:From January 2019 to December 2020, consecutive patients with severe carotid artery stenosis (stenosis degree ≥70%) treated in the Department of Neurology, Bozhou People's Hospital were selected. According to different treatment schemes, all patients were divided into a CAS group and a control group. The CAS group received CAS combined with the best drug treatment, while the control group only received the best drug treatment. The cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) before treatment and at 6 months after treatment.Results:During the study, 52 patients with severe carotid artery stenosis were enrolled, including 37 patients in the CAS group and 15 in the control group. There were no significant differences in demographic and baseline clinical data between the two groups. All patients in the CAS group completed procedure successfully without any complications. MoCA score in the CAS group was significantly higher than that before treatment ( P<0.001), but not in the control group. There was no significant difference in MoCA score between the patients in the CAS group and the control group before treatment; the MoCA score in the CAS group was significantly higher than that in the control group at 6 months after treatment ( P=0.007). Conclusion:CAS may improve the short-term postoperative cognitive function of patients with severe carotid artery stenosis.
ABSTRACT
Objective@#To investigate the correlation between the level of serum homocysteine (Hcy) and early neurological deterioration (END) in patients with acute ischemic stroke.@*Methods@#From June 2018 to August 2019, consecutive patients with acute ischemic stroke within 24 h of onset admitted to Bozhou People's Hospital were enrolled retrospectively. Their baseline cilinical data, imaging and laboratory findings were collected. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased ≥2 or the motor item score increased ≥1 within 72 h of onset compared with the baseline. Univariate analysis was used to compare the demography, vascular risk factors, baseline blood pressure, laboratory findings, etiological typing of stroke, stroke distribution and the time from onset to admission between the END group and non-END group. Multivariate logistic regression analysis was used to identify the independent risk factors for END.@*Results@#A total 112 patients with acute ischemic stroke were enrolled, among them, 29 (25.9%) occurred END. Univariate analysis showed that there were significant differences in baseline NIHSS score (Z=4.653, P<0.001), C-reactive protein (CRP) (t=2.437, P=0.017), fasting blood glucose (t=2.781, P=0.006), Hcy (t=3.932, P<0.001) and glycated hemoglobin (t=2.107, P=0.047) between the END group and the non-END group. Multivariate logistic regression analysis showed that high baseline NIHSS score (odds ratio [OR] 1.566, 95% confidence interval [CI] 1.237-1.982; P=0.015), CRP >10 mg/L (OR 3.138, 95% CI 1.871-5.362; P=0.030), fasting blood glucose >6.1 mmol/L (OR 2.529, 95% CI 1.736-4.651; P=0.027), and Hcy >15 μmol/L (OR 3.542, 95% CI 1.295-9.461; P=0.038) were the independent risk factors for END in patients with acute ischemic stroke.@*Conclusion@#The elevated baseline serum Hcy level was an independent risk factor for END in patients with acute ischemic stroke.