한빛사논문
- 조회596
Jun Young Chang 1, Ji Sung Lee 2, Wook-Joo Kim 3, Jee Hyun Kwon 3, Beom Joon Kim 4, Joon-Tae Kim 5, Jun Lee 6, Jae Kwan Cha 7, Dae-Hyun Kim 7, Yong-Jin Cho 8, Keun-Sik Hong 8, Soo Joo Lee 9, Jong-Moo Park 10, Kyusik Kang 11, Byung-Chul Lee 12, Kyung-Ho Yu 12, Sang-Hwa Lee 13, Chulho Kim 13, Kwang-Yeol Park 14, Dong-Eog Kim 15, Kyungbok Lee 16, Tai Hwan Park 17, Jay Chol Choi 18, Dong-Ick Shin 19, Sung-Il Sohn 20, Hee-Joon Bae 4, Moon-Ku Han 4; CRCS-K-NIH (Clinical Research Collaboration for Stroke in Korea-National Institutes of Health) investigators
1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2Clinical Research Center, Asan Medical Center, Seoul, Korea.
3Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
4Department of Neurology and Cerebrovascular Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
5Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
6Department of Neurology, Yeungnam University Medical Center, Daegu, Korea.
7Department of Neurology, Dong-A University Hospital, Busan, Korea.
8Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea.
9Department of Neurology, Eulji University Hospital, Daejeon, Korea.
10Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea.
11Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
12Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
13Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
14Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
15Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.
16Department of Neurology, Soonchunhyang University Hospital, Seoul, Korea.
17Department of Neurology, Seoul Medical Center, Seoul, Korea.
18Department of Neurology, Jeju National University Hospital, Jeju, Korea.
19Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea.
20Department of Neurology, Keimyung University Dongsan Hospital, Daegu, Korea.
CORRESPONDING AUTHORS: Jun Young Chang MD, PhD, Moon-Ku Han MD, PhD
Abstract
Objective: We evaluated the efficacy of endovascular thrombectomy (EVT) on the functional outcome of patients with acute basilar artery occlusion and low posterior circulation acute stroke prognosis early computed tomography score (PC-ASPECTS).
Methods: We identified patients with acute ischemic stroke due to basilar artery occlusion and PC-ASPECTS of 6 or less, presenting within 24 h between August 2008 and April 2022. The primary outcome was a favorable functional outcome, defined as a modified Rankin Scale (mRS) score of 0-3 at 90 days. The secondary outcomes included an mRS score of 0-2, a favorable shift in the ordinal mRS scale, the occurrence of symptomatic intracranial hemorrhage (sICH), and mortality at 90 days. We compared the outcome of patients treated with EVT and those without EVT, using the inverse probability of treatment weighting methods.
Results: Out of 566 patients, 55.5% received EVT. In the EVT group, 106 (33.8%) achieved favorable outcomes, compared to 56 patients (22.2%) in the conservative group. EVT significantly increased the likelihood of achieving a favorable outcome compared to conservative treatment (relative risk [RR] 1.39, 95% confidence interval [CI], 1.11-1.74, p = 0.004). EVT was associated with a favorable shift in the mRS (RR 1.85, 95% CI, 1.49-2.29, p < 0.001) and reduced mortality without an increase in the risk of sICH. It did not have an impact on achieving an mRS score of 0-2.
Interpretation: Patients with acute basilar artery occlusion and a PC-ASPECTS of 6 or less might benefit from EVT without an increasing sICH. ANN NEUROL 2024.
논문정보
- Research article
- 2024년 02월 (BRIC 등록일 2024-02-23)
- 국내 연구진
- 의약학 > 신경의학
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