Analysis Of The Prognostic Factors Of Mechanical Embolectomy For Acute Basilar Artery Occlusion

Objective: By reviewing the relevant data of patients with acute basilar artery occlusion who received thrombectomy,this paper aims to analyze the relevant factors affecting the prognosis after thrombectomy and evaluate the predictive value of various factors on the prognosis,so as to better guide the treatment,improve the recanalization rate of intravascular therapy,improve the prognosis of patients with a BAO.Methods: Patients diagnosed with acute basilar artery occlusion and receiving emergency thrombectomy treatment in Shengjing Hospital Affiliated to China Medical University from October 2017 to October 2022 were screened,and patients meeting the criteria were strictly selected and included in this study according to the exclusion criteria formulated in this study.Relevant data of patients were collected,and several different posterior circulation scoring criteria were used to evaluate the posterior circulation collateral compensation of patients.According to the m RS Scoring results 3 months after surgery,all patients were divided into good prognosis group and poor prognosis group.Univariate analysis and multivariate Logistic regression analysis were used to analyze the influence of each index on the prognosis of patients.ROC curves were plotted for the four preoperative imaging scores,and the area under the curve(AUC)was calculated to evaluate its predictive value for prognosis.Results: A total of 88 patients were included,including 35 patients in the good prognosis group(39.77%),53 patients in the poor prognosis group(60.23%),17 patients in the death group(19.32%),82 patients in the complete recalculation after surgery,the rate of complete recalculation after surgery was 93.18%(82/88).The results of univariate analysis showed that the form of onset(P=0.04),DSA collateral grading(P=0.001),preoperative NIHSS score(P<0.005),onset-treatment time(P=0.005),PC-CS score(P=0.005),PC-CTA score(P<0.001),and BATMAN score(P=<0.001)were statistically significant.ROC curve was drawn to compare the four scoring standards,and the results showed that the area under the BATMAN scoring curve was 0.755(95%CI:0.647-0.862),the area under the PC-CS scoring curve is 0.658(95%CI:0.532-0.781),the area under the PC-CTA scoring curve is 0.717(95%CI:0.605-0.829),the area under the curve of DSA lateral classification system is 0.673(95%CI:0.557-0.789);The results of logistic regression analysis showed that the preoperative NIHSS score(OR=1.165,95%CI:1.054-1.288,P=0.003),BATMAN score(OR=0.637,95%CI:0.445-0.971,P=0.013)and the time from onset to treatment(OR=0.995,95%CI:0.990-0.999,P=0.025)were the influencing factors for the prognosis of a BAO patients.Conclusion: The risk factors of poor prognosis in patients with a BAO are the long time from onset to admission,high preoperative NIHSS score and low BATMAN score;The four preoperative imaging scoring criteria have certain predictive value for the prognosis of patients,among which the BATMAN score has the best predictive effect.