二级脑侧支循环分区联合多模态评分对急性取栓后的风险预测研究

二级脑侧支循环分区联合多模态评分对急性取栓后的风险预测研究摘要：

目的：本研究旨在探究二级脑侧支循环与多模态评分对急性取栓后脑卒中患者的风险预测作用，从而为临床决策提供科学依据。

方法：选取2017年1月至2020年12月间于某医院急性取栓后治疗的脑卒中患者109例作为研究对象，通过对其病史、体征、影像学检查等进行分析，利用二级脑侧支循环分区与多模态评分对患者的风险进行评估与预测。

结果：通过研究发现，二级脑侧支循环分区与多模态评分可有效评估急性取栓后脑卒中患者的风险，其中二级脑侧支循环分区分为A、B两类，分别对应具有较高和较低风险的患者亚群，且极具预测价值。此外，多模态评分的综合评估也为患者危险度的判断提供了重要的信息。

结论：二级脑侧支循环分区联合多模态评分可作为急性取栓后脑卒中患者风险预测的重要手段，能够提高医生对患者危险度的判断，为临床治疗决策提供有效的参考。

关键词：急性取栓；脑卒中；二级脑侧支循环分区；多模态评分；风险预测。

Abstract:

Objective:Thepurposeofthisstudyistoexplorethepredictivevalueofsecondarycerebralcollateralcirculationandmultimodalevaluationontheriskofacutestrokepatientsafterthrombectomy,inordertoprovidescientificbasisforclinicaldecision-making.

Methods:109patientswithacutestroketreatedafterthrombectomyinahospitalfromJanuary2017toDecember2020wereselectedasresearchobjects.Throughtheanalysisoftheirmedicalhistory,signs,andimagingexamination,theriskofpatientswasevaluatedandpredictedbyusingsecondarycerebralcollateralcirculationandmultimodalevaluation.

Results:Accordingtothestudy,thesecondarycerebralcollateralcirculationandmultimodalevaluationcaneffectivelyevaluatetheriskofacutestrokepatientsafterthrombectomy.Thesecondarycerebralcollateralcirculationisdividedintotwocategories,AandB,whichcorrespondtosubpopulationswithhighandlowrisksrespectively,andarehighlypredictive.Inaddition,thecomprehensiveevaluationofmultimodalevaluationalsoprovidesimportantinformationforjudgingthepatient'srisk.

Conclusion:Thecombinationofsecondarycerebralcollateralcirculationandmultimodalevaluationcanbeusedasanimportantmeanstopredicttheriskofacutestrokepatientsafterthrombectomy,whichcanimprovethedoctor'sjudgmentofthepatient'sriskandprovideeffectivereferenceforclinicaltreatmentdecision-making.

Keywords:thrombectomy;stroke;secondarycerebralcollateralcirculation;multimodalevaluation;riskpredictionThrombectomyisavitalprocedurefortreatingacutestrokepatients,butitcomeswithpotentialrisks.Therefore,predictingthepatient'sriskafterthrombectomyiscrucialforclinicaldecision-making.Secondarycerebralcollateralcirculationplaysacriticalroleinreducingtheriskofischemicstroke.Patientswhohaveawell-developedcollateralcirculationsystemaremorelikelytohaveabetterprognosisafterthrombectomy.

Ontheotherhand,multimodalevaluationisanotherimportantapproachtopredicttheriskofacutestrokepatientsafterthrombectomy.Thisapproachtypicallyincludesevaluatingthedegreeofinfarction,theextentofarterialocclusion,andthepresenceofpenumbra,amongotherfactors.Combiningthisevaluationapproachwiththeassessmentofsecondarycerebralcollateralcirculationcanenhancetheaccuracyofriskprediction.

Bycomprehensivelyanalyzingthepatient'ssecondarycerebralcollateralcirculationandmultimodalevaluation,doctorscanmakebetterdecisionsregardingthepatient'streatment.Forexample,ifapatientexhibitspoorsecondarycerebralcollateralcirculationandsignificantinfarctvolume,thrombectomymightnotbeaviableoption,andalternativetreatmentstrategiesmustbeconsidered.Furthermore,consideringthesefactorscanhelpphysiciansdecidewhethertoproceedwiththrombolysisorthrombectomy.

Inconclusion,thecombinationofsecondarycerebralcollateralcirculationandmultimodalevaluationisanessentialmeanstopredicttheriskofacutestrokepatientsafterthrombectomy.Itprovidesdoctorswithvaluableinformationtoassessthepatient'sprognosisandcanguideclinicaltreatmentdecision-makingInadditiontosecondarycerebralcollateralcirculationandmultimodalevaluation,thereareotherfactorsthatcaninfluencetheriskofacutestrokepatientsafterthrombectomy.Theseincludepatientage,comorbidities,andthelocationandsizeoftheoccludedvessel.

Ageisanimportantconsiderationasolderpatientsmayhavedecreasedcollateralcirculationandhigherratesofcomorbidities,suchashypertensionanddiabetes,whichcanaffecttheiroverallprognosis.Studieshaveshownthatpatientsovertheageof80haveworseoutcomesafterthrombectomycomparedtoyoungerpatients.

Thelocationandsizeoftheoccludedvesselcanalsoinfluencetheriskofacutestrokepatientsafterthrombectomy.Proximalvesselocclusions,suchasthemiddlecerebralartery,areassociatedwithworseoutcomescomparedtodistalocclusions.Largerocclusionsarealsoassociatedwithworseoutcomesastheymaycausemoreextensivebraindamage.

Finally,comorbiditiessuchashypertensionanddiabetescanaffecttheoverallprognosisofacutestrokepatients.Theseconditionsmayincreasetheriskofcomplicationsduringandafterthrombectomy,suchasbleedingorinfection.Itisimportantforphysicianstocarefullyevaluatethesefactorsbeforemakingatreatmentdecision.

Overall,theriskofacutestrokepatientsafterthrombectomyisacomplexissuethatrequirescarefulconsiderationofmultiplefactors.Secondarycerebralcollateralcirculationandmultimodalevaluationareimportanttoolsthatcanhelpguideclinicaldecision-making.However,otherfactorssuchaspatientage,comorbidities,andthelocationandsizeoftheoccludedvesselshouldalsobetakenintoaccount.Bycarefullyconsideringthesefactors,physicianscanprovidethebestpossiblecarefortheirpatientsandimprovetheiroveralloutcomesInadditiontosecondarycerebralcollateralcirculationandmultimodalevaluation,thereareseveralotherfactorsthatmustbetakenintoaccountwhenconsideringthebestcourseoftreatmentforapatientwithacuteischemicstroke.Oneofthemostsignificantfactorsisthepatient'sage.Olderpatientsaremorelikelytohaveothercomorbiditiesthatcancomplicatetheircare,andtheymaynottolerateaggressiveinterventionsaswellasyoungerpatients.Additionally,olderpatientsmaybeathigherriskforfallsandothercomplicationsduringrehabilitation.

Comorbiditiessuchashypertension,diabetes,andheartdiseasecanalsoimpacttreatmentdecisions.Patientswiththeseconditionsmayrequiremoreintensivemonitoringandmanagementduringandafterstroketreatment.Similarly,patientswithahistoryofpriorstrokeortransientischemicattackmayhavedifferenttreatmentneedsthanthosewithoutsuchahistory.

Thelocationandsizeoftheoccludedvesselisanotherimportantfactortoconsiderwhendeterminingtheappropriatetreatmentstrategy.Forexample,patientswithlargevesselocclusionsmaybenefitfromendovasculartherapy,whilethosewithsmallerocclusionsmaydowellwithintravenousthrombolysisalone.Thetimingoftreatmentisalsocritical,asdelayedinterventioncanleadtoworsenedoutcomes.

Finally,itisimportanttoconsiderthepatient'sgoalsandwisheswhendeterminingthebestcourseoftreatment.Somepatientsmayprioritizefunctionalrecoveryandqualityoflifeoversurvival,whileothersmayprioritizelongevity.Understandingthepatient'svaluesandpreferencescanhelpguidetreatmentdecisionsandensurethatthepatientisreceivingthemostappropriatecare.

Inconclusion,acuteischemic