Predictive value of posterior circulation acute stroke prognosis early CT score on CTA source image in the outcome of endovascular treatment for acute vertebrobasilar occlusion
Gao Jun, Wen Changming, Sun Jun, Chen Di, Zhang Donghuan, Wang Ning, Liu Yifeng, Zhang Baochao
Department of Neurology, Nanyang Central Hospital, Nanyang 473000, China
Abstract：Objective To explore the predictive value of posterior circulation acute stroke prognosis early CT score on CT angiography(CTA)posterior circulation acute stroke prognosis early CT(pc-ASPECTs) in the outcome of endovascular treatment for acute vertebrobasilar occlusion (AVBO).Methods Thirty-five patients with AVBO diagnosed by preoperative CTA images from January 2018 to January 2020 in Nanyang Central Hospital were retrospectively analyzed. There were 25 males and 10 females, aged 34-84(62.40±13.46) years. All patients received endovascular treatment. Vascular recanalization was assessed using the blood flow grade after modified thrombolysis in cerebral infarction (mTICI) treatment; the modified Rankin Scale (mRS) score at 3 months after treatment was used to assess the clinical prognosis at 3 months after surgery. According to the prognosis of patients, they were divided into good and poor prognosis groups, and univariate analysis was conducted. Receiver operating characteristic (ROC) curve analysis was performed for the CTA pc-ASPECT score of the good prognosis group to determine the area under the curve and the optimal cut-off point. Multivariate logistic regression analysis was performed to identify independent predictors of the 3-month clinical outcome.Results Among the 35 patients, 34 patients (97.1%) had successful recanalization, 22 patients (62.9%) had a good clinical prognosis, and 6 patients had intraoperative complications of distal embolization of the target vessel. The National Institute of Health stroke scale and CTA pc-ASPECT scores between the good and poor prognosis groups in univariate analysis (all P values＜0.1), and were included into multivariate analysis. ROC analysis of the CTA pc-ASPECT score of the good prognosis group revealed an area under the curve of 0.930 (95% confidence interval [CI]=0.850-1.000) and optimal cut-off value of 7.5 points (sensitivity=72.7% and specificity=100%). Multivariate logistic regression analysis showed that the CTA pc-ASPECT score ≥8 was an independent predictor of a good 3-month outcome after endovascular treatment of AVBO (odds ratio=23.850, 95% CI=2.005-283.704, P＜0.05).Conclusions The CTA pc-ASPECT score can independently predict the short-term clinical prognosis of patients with AVBO treated with endovascular treatment.
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Gao Jun, Wen Changming, Sun Jun, Chen Di, Zhang Donghuan, Wang Ning, Liu Yifeng, Zhang Baochao. Predictive value of posterior circulation acute stroke prognosis early CT score on CTA source image in the outcome of endovascular treatment for acute vertebrobasilar occlusion. Chinese Journal of Anatomy and Clinics, 2021, 26(4): 425-430.
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2021, Vol. 26 
