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Artery diameter ratio after recanalization in endovascular therapy for acute ischemic stroke: a new predictor of clinical outcomes

  • Interventional Neuroradiology
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Abstract

Purpose

This study aimed to investigate the relationship between the artery diameter ratio (ADR) after recanalization and clinical outcomes.

Methods

Patients with middle cerebral artery occlusion confirmed by DSA from 1 January 2018, to 31 December 2019, were retrospectively analyzed. All patients confirmed TICI grade 2b or 3. The ADR was calculated as M2 segment diameter/M1 segment diameter. Multivariate regression analysis was used to describe clinical outcomes of two groups (ADR < 0.6 and ≥ 0.6). ROC curves were used to compare different models and find the best cutoff.

Results

A total of 143 patients were included in the study, including 77 males and 66 females, with an average age of 67.79 ± 12 years. The NIHSS at discharge was significantly higher in the ADR < 0.6 group than another group (mean, 16.37 vs. 6.19, P < 0.001). At 90 days, the cases of functional independence was significantly less in the ADR < 0.6 group (20.97% vs. 83.95%, OR 0.05, 95% CI 0.02–0.12, P < 0.001). The ADR < 0.6 group had a higher incidence of cerebral edema (P = 0.027) and sICH (P = 0.038). The ADR had the strongest power to distinguish mRS > 2 (AUC = 0.851) and DC (AUC = 0.805), and the best cutoff value are 0.6 (specificity 85.19%, sensitivity 75.81%) and 0.58 (specificity 65.96%, sensitivity 100%), respectively.

Conclusion

The low ADR is associated with poor outcomes. The decrease in ADR may be an indirect manifestation of the loss of cerebrovascular autoregulation.

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Acknowledgements

Special thanks to all colleagues for their contribution to this study and continued support. And also special thanks to ZL for the helping in statistical analysis and figure production.

Funding

The research belongs to a topic of clinical therapy technology of acute ischemic stroke (item number: 2018XLC2022) and received some grant from it.

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Authors and Affiliations

  1. Department of Neurology, Army Medical Center of PLA, Army Medical University, 400042, Chongqing, China

    Shuhan Huang, Chengchun Liu, Xiaoshu Li, Ya Wu, Chunrong Liang, Wei Li & Meng Zhang

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  1. Shuhan Huang
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  2. Chengchun Liu
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  3. Xiaoshu Li
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  4. Ya Wu
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Contributions

SH and MZ participated in the conception and design of the study. SH, XL, YW, and WL analyzed and interpreted the data. SH, CL, and MZ treated and included the patients in the study. SH and ZL performed the statistical analysis and wrote the article. All the authors read, reviewed, and approved the manuscript.

Corresponding author

Correspondence to Meng Zhang.

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Ethical approval was obtained from the Ethics Committee of Army Medical Center of PLA Approval of Medical Research Involving People Ethical.

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All authors declare that they have no competing interests.

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Huang, S., Liu, C., Li, X. et al. Artery diameter ratio after recanalization in endovascular therapy for acute ischemic stroke: a new predictor of clinical outcomes. Neuroradiology 64, 785–793 (2022). https://doi.org/10.1007/s00234-021-02841-5

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