Influence of moderate to severe leukoaraiosis in prognoses of acute ischemic stroke patients after endovascular treatment

Objective To investigate the influence of moderate to severe leukoaraiosis (LA) in prognoses of acute ischemic stroke patients after endovascular treatment. Methods From January 2017 to December 2018, 60 patients with acute ischemic stroke due to anterior circulation large vessel occlusion underwent endovascular treatment and obtained complete vessel recanalization in our hospital were evaluated for degrees of LA severity according to head CT scan and van Swieten scale (2-4 scores were defined as moderate-severe LA). According to modified Rankin scale (mRS) scores 90 d after treatment, the patients were divided into poor prognosis group and good prognosis group. Univariate analysis was used to compare the differences of influencing factors of the two groups. Multivariate Logistic regression analysis was further used to explore the influence of moderate to moderate-severe LA in poor prognosis of patients after endovascular treatment. Results Of the 60 patients, 18 did not have LA, 19 had mild LA, and 23 had moderate-severe LA; 32 had poor prognosis and 28 had good prognosis. Univariate analysis showed that the patients from the poor prognosis group had significantly higher proportion of moderate-severe LA (59. 4% [19/32] vs. 14.3% [4/28]), significantly higher baseline National Institutes of Health Stroke Scale (NIHSS) scores ([23.4±10.1] vs. [14.7±7.0]), significantly higher baseline diastolic blood pressure ([87.5±18.9] mmHg vs. [78.3±15.1] mmHg), significantly higher proportion of patients with hypertension history (68.8% [22/32] vs. 42.9% [12/28]), and statistically older age ([70.6±9.4] years vs. [61.3±12.5] years) than the patients from the good prognosis group (P<0.05). On multivariable Logistic regression analysis, the presence of moderate-severe LA (OR=5.032, 95%CI: 1.026-24.679, P=0.046) and baseline NIHSS scores were independent risk factors for poor prognosis of patients after endovascular treatment. Conclusion Patients with acute ischemic stroke accompanied with moderate-severe LA are more likely to have poor prognosis after endovascular treatment. Key words: Leukoaraiosis; Ischemic stroke; Endovascular treatment; Prognosis