Objective: To analyze the related factors of futile recanalization (FR) after emergency endovascular treatment of large artery occlusion in anterior circulation. Methods: Three studies on endovascular treatment of acute anterior circulation large vessels occlusion stroke were selected, and their data were merged for retrospective analysis. Patients were divided into the FR group and favorable prognosis group according to the functional prognosis. Risk factor analysis was conducted using multivariate logistic regression. Results: A total of 1 581 patients were finally included, with 858 (48.9%) patients in favorable prognosis group and 926 (51.91%) patients in FR group. Among them, there were 939 males and 642 females, with a mean age of (65±12) years. Multivariate logistic regression analysis showed that National Institute of Health Stroke Scale (NIHSS) score (OR=1.089,95%CI:1.066-1.113), puncture to recanalization time (OR=0.756, 95%CI:0.586-0.971), age (OR=1.04,95%CI:1.029-1.051), serum glucose (OR=1.101,95%CI:1.062-1.143), systolic blood pressure (OR=1.005,95%CI:1.001-1.010), passes≥3(OR=1.941,95%CI:1.294-2.941)Alberta stroke program early CT (ASPECT) score (OR=0.919,95%CI:0.847-0.996), occlusion site (M1 segment of middle cerebral artery, OR=0.744,95%CI:0.565-0.980) and collateral circulation [(2 points, OR=0.757, 95%CI:0.581-0.985); (3-4 points, adjusted OR=0.640, 95%CI: 0.472-0.866)] were independent factors of FR. Conclusion: The incidence of FR in patients with large artery occlusion in anterior circulation who achieve satisfied reperfusion after endovascular treatment is high. Higher NIHSS score, longer puncture to recanalization time, older age, higher serum glucose and systolic blood pressure are risk factors, while lower ASPECTS, occlusion in cerebral middle M1 segment, better collateral circulation are protective factors.
目的： 分析急性前循环大血管闭塞性卒中血管内治疗后患者无效再通（FR）的相关因素。 方法： 选择三项关于急性前循环大血管闭塞性卒中血管内治疗的研究，将其数据合并后进行回顾性分析。根据患者神经功能预后情况分为FR组和预后良好组，采用多因素logistic回归模型对预后的危险因素进行分析。 结果： 本研究共计纳入1 581例患者的临床资料，其中男939例，女642例，年龄（65±12）岁，预后良好组858例（48.09%），无效再通组926例（51.91%）。多因素logistic回归模型分析显示美国国立卫生院卒中量表（NIHSS）评分较高（OR=1.089，95%CI：1.066~1.113）、穿刺到再通时间（PTR）较长（OR=1.004，95%CI：1.001~1.006）、年龄较大（OR=1.04，95%CI：1.029~1.051）、血糖水平较高（OR=1.101，95%CI：1.062~1.143）、收缩压水平较高（OR=1.005，95%CI：1.001~1.010）、取栓通过次数≥3次（OR=1.941，95%CI：1.294~2.941）、Alberta卒中项目早期CT评分（ASPECTS）较高（OR=0.919，95%CI：0.847~0.996）、闭塞部位（大脑中动脉M1段，OR=0.744，95%CI：0.565~0.980）和侧支循环好［（2分，OR=0.757，95%CI：0.581~0.985）；3~4分，OR=0.640，95%CI：0.472~0.866）］和FR相关。 结论： 急性前循环大血管闭塞性脑梗死血管再通治疗后FR发生率高，其危险因素为NIHSS评分较高、PTR较长、年龄较大、血糖和收缩压水平较高，保护因素为ASPECTS较高、大脑中动脉M1段闭塞、侧支循环好。.