医学
曲折
置信区间
优势比
闭塞
大脑中动脉
计算机断层血管造影
磁共振血管造影
血管造影
冲程(发动机)
磁共振成像
支架
放射科
核医学
心脏病学
内科学
缺血
机械工程
岩土工程
多孔性
工程类
作者
Takao Hoshino,Shinsuke Sato,Kazuki Kushi,Yukiko Tanaka,Tatsuki Mochizuki,Tomomi Ishikawa,Shogo Shima,Bikei Ryu,Tatsuya Inoue,Yoshikazu Okada,Yasunari Niimi
标识
DOI:10.1177/15910199221104922
摘要
Background We aimed to quantify the tortuosity of the middle cerebral artery (MCA) and assess its effects on radiological and clinical outcomes in patients with acute MCA occlusions who received mechanical thrombectomy (MT). Methods This retrospective study enrolled 53 patients with acute ischemic stroke due to MCA M1 or M2 segment occlusion who underwent MT using stent retrievers (SRs). Tortuosity index (TI) was defined to quantify the tortuosity of the MCA M1 segment using the following formula: (actual distance / straight distance) × 100. For each patient, four TIs were measured in the anteroposterior and caudal views for both ipsilateral and contralateral sides to the occluded site (TI-APi, TI-APc, TI-CAUi, and TI-CAUc, respectively) using magnetic resonance angiography (MRA) or computed tomography angiography (CTA). We defined the first-pass effect (FPE) as first-pass mTICI classification ≥2b reperfusion. Results Patients who did not achieve FPE had significantly higher TI-APi (112 vs. 106; P = 0.004), TI-APc (111 vs. 105; P = 0.005), TI-CAUi (110 vs. 105; P = 0.002), and TI-CAUc (110 vs. 105; P = 0.001) than those who achieved FPE. In multivariable analysis, higher TI-APi, TI-CAUi, and TI-APc were independently associated with an increased rate of unsuccessful FPE (odds ratio (OR) [95% confidence interval (CI)]: 1.25 [1.02–1.61], 1.21 [1.01–1.45], and 1.27 [1.03–1.73], respectively). TI-CAUi, TI-APc, and TI-CAUc were also independent predictors of the occurrence of intracranial hemorrhage after MT (OR [95% CI]: 1.15 [1.01–1.38], 1.14 [1.01–1.38], 1.25 [1.02–1.52], respectively). Conclusions The TIs of the MCA M1 segment on both ipsilateral and contralateral sides were associated with unfavourable outcomes after MT.
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