BACKGROUND Intravenous thrombolysis therapy (IVT) bridged with intra-arterial thrombectomy (IAT) has recently been recommended as favorable treatment option to ensure that the thrombolytic effect is delivered to the affected region for acute ischemic stroke patients. However, there remains a lack of studies reporting outcome prediction in this group of patients. In this study, we aimed to identify indicators from baseline data that could be used for early prediction of long-term functional outcomes. METHODS This retrospective single center cohort study included acute ischemic stroke (AIS) patients (n = 92) who received IVT and IAT. Functional outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Barthel Index. We investigated the relationship between functional outcomes at one-year post-procedure and potential predictors such as occlusion site, modified thrombolysis in cerebral infarction (mTICI) score following the IVT/IAT procedure, and degree of stenosis measured by carotid duplex. RESULTS 67.4% of the studied patients had satisfactory outcomes with mTICI grades of 2b or 3. From baseline to one-year post-procedure, the NIHSS score improved in 88.0%, the mRS score improved in 69.6%, and the Barthel index improved with 59.8%. Patients with internal carotid artery (ICA) or vertebral artery (VA) stenosis detected by carotid duplex had significantly poorer functional outcomes, measured by the mRS score and Barthel index. In patients with a satisfactory mTICI grade, improvement in the mRS score was only observed in 60.0% of patients with ICA stenosis, compared to 93.8% without ICA stenosis. The VA stenosis was the most significant factor associated with the improvement of mRS (OR = 0.08; 95% CI: 0.01-0.63; P = 0.017) and Barthel Index (OR = 0.06; 95% CI: 0.01-0.47; P = 0.008) in multiple regression analysis. CONCLUSIONS ICA or VA stenosis detected by carotid duplex could serve as predictors of significantly poorer functional outcomes in stroke patients treated with bridging therapy; they might be useful clinical markers, particularly as stenosis could be detected by a non-invasive and portable method.

中文翻译：

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桥接疗法治疗急性缺血性中风患者长期功能预后的预测。

背景技术近来，推荐将静脉内溶栓治疗（IVT）与动脉内血栓切除术（IAT）桥接作为有利的治疗选择，以确保对于急性缺血性中风患者将溶栓作用传递到受影响的区域。但是，仍然缺乏研究报告对这一组患者的结果预测。在这项研究中，我们旨在从基线数据中确定指标，这些指标可用于早期预测长期功能结局。方法这项回顾性单中心队列研究包括接受IVT和IAT的急性缺血性卒中（AIS）患者（n = 92）。通过美国国立卫生研究院卒中量表（NIHSS），改良的兰金量表（mRS）和Barthel指数评估功能结局。我们调查了术后一年的功能结局与潜在预测因素（如闭塞部位，IVT / IAT程序后脑梗塞的改良溶栓（mTICI）评分）以及通过颈动脉双工测量的狭窄程度之间的关系。结果67.4％的患者mTICI等级为2b或3时，其结果令人满意。从基线到术后1年，NIHSS评分改善了88.0％，mRS评分改善了69.6％，Barthel指数改善了59.8％。通过mRS评分和Barthel指数测量，通过颈动脉双工检测到的颈内动脉（ICA）或椎动脉（VA）狭窄的患者的功能结局明显较差。在mTICI评分满意的患者中，仅在60.0％的ICA狭窄患者中观察到mRS评分有所改善，相比无ICA狭窄的93.8％。VA狭窄是与mRS改善相关的最重要因素（OR = 0.08; 95％CI：0.01-0.63; P = 0.017）和Barthel Index（OR = 0.06; 95％CI：0.01-0.47; P = 0.008 ）进行多元回归分析。结论颈动脉双工检测到的ICA或VA狭窄可以作为桥接治疗的卒中患者功能预后显着降低的指标。它们可能是有用的临床标志物，特别是因为可以通过非侵入性和便携式方法检测狭窄。结论颈动脉双工检测到的ICA或VA狭窄可以作为桥接治疗的卒中患者功能预后显着降低的指标。它们可能是有用的临床标志物，特别是因为可以通过非侵入性和便携式方法检测狭窄。结论颈动脉双工检测到的ICA或VA狭窄可以作为桥接治疗的卒中患者功能预后显着降低的指标。它们可能是有用的临床标志物，特别是因为可以通过非侵入性和便携式方法检测狭窄。