- 作者：Valerio Da Ros ; MD* ; valeriodaros@hotmail.com" class="auth_mail" title="E-mail the corresponding author ; Alessandro Meschini ; MD ; PhD* ; Roberto Gandini ; Associate Professor of Interventional Radiology* ; Costantino Del Giudice ; MD* ; Francesco Garaci ; Associate Professor of Neuroradiology* ; Paolo Stanzione ; Full Professor of Neurology&dagger ; ; Barbara Rizzato ; MD&dagger ; ; Marina Diomedi ; MD&dagger ; ; Giovanni Simonetti ; Full professor of Radiology* ; Roberto Floris ; Full Professor of Neuroradiology* ; Fabrizio Sallustio ; MD&dagger ; ; &Dagger ;
- 关键词：Stroke ; basilar artery ; ASPECTS ; computed tomography angiography ; neurothrombectomy
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2016
- 出版时间：February 2016
- 年：2016
- 卷：25
- 期：2
- 页码：368-377
- 全文大小：896 K
Methods
A CTA and digital subtraction angiography (DSA) retrospective analysis of patients with acute vertebrobasilar stroke treated with thrombectomy was performed. A modified Rankin Scale score of 3 or lower at 3 months was considered as favorable outcome. The posterior circulation ASPECTS (pc-ASPECTS) was evaluated on CTA and vertebrobasilar segments involved in the occlusion were assessed using a 6-point posterior circulation computed tomography angiography (pc-CTA) vascular score aimed at evaluating the posterior circulation vascular pattern including collaterals. The primary end point was the correlation between pc-CTA and outcome; secondary end points included the concordance between CTA–DSA images and the correlation between pc-ASPECTS and outcome.
Results
Fifteen patients with vertebrobasilar stroke were retrospectively analyzed. All patients in coma showed a bad outcome (P = .01) and all patients with an alert state showed a good outcome (P = .004). An excellent interobserver agreement for pc-CTA (P = .001) was observed with poor interobserver agreement for pc-ASPECTS (P = .21). No significant correlations between pc-ASPECTS and clinical outcome were observed. Patients with good outcome had a lower pc-CTA (P = .02). The patency of the distal third of the basilar artery and both posterior cerebral arteries was related with good outcome.
Conclusion
The pc-CTA seems to have prognostic value in patients with vertebrobasilar stroke undergoing mechanical thrombectomy. It may be used as an additional prognostic triage technique in this subgroup of stroke patients.