Effect of the time from onset to recanalization on the outcomes after endovascular treatment in patients with acute stroke due to posterior circulation large vessel occlusion / 国际脑血管病杂志

ABSTRACT

Objective@#To investigate the effect of the time from onset to recanalization on the outcomes after endovascular treatment (EVT) in patients with acute stroke due to posterior circulation large vessel occlusion.@*Methods@#From May 2015 to May 2019, patients with acute ischemic stroke due to posterior circulation large vessel occlusion receiving EVT in the Department of Neurology, Nanjing First Hospital, Nanjing Medical University were enrolled retrospectively. According to the modified Rankin Scale (mRS) score at 90 d after procedure, they were divided into good outcome group (≤2) and poor outcome group (>2). Demographic and clinical data were compared between the two groups. Multivariate logistic regression analysis was used to determine the independent correlation between the time from onset to recanalization and the outcomes.@*Results@#A total of 64 patients with acute ischemic stroke due to posterior circulation large vessel occlusion treated by EVT were enrolled in this study. There were 50 males (78.0%) and 14 females (22.0%). The age was 67.52±10.30 years. The National Institutes of Health Stroke Scale (NIHSS) score was 22.04±4.17, and the time from onset to recanalization was 370.53±78.59 min. Thirty-one patients (48.0%) were in the good outcome group and 33 (52.0%) were in the poor outcome group. There were significant differences in baseline NIHSS score, systolic blood pressure, time from onset to revascularization, and the proportions of patients with tandem lesion and symptomatic intracranial hemorrhage between the two groups (all P<0.05). Multivariate logistic regression analysis showed that the longer time from onset to recanalization (odds ratio [OR] 1.317, 95% confidence interval [CI] 1.001-3.034; P=0.041) and symptomatic intracranial hemorrhage (OR 4.207, 95% CI 1.931-10.761; P=0.004) were the independent predictors of poor outcomes, while the lower baseline NIHSS score (OR 0.302, 95% CI 0.056-0.743; P=0.047) was the independent protective factor of poor outcomes.@*Conclusions@#The longer time from onset to recanalization is an independent risk factor for poor outcomes after EVT in patients with acute ischemic stroke caused by posterior circulation large vessel occlusion.