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Compromised dynamic cerebral autoregulation is a hemodynamic marker for predicting poor prognosis even with good recanalization after endovascular thrombectomy

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机构： [1]Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China. [2]Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Xicheng, Beijing, China. [3]Department of Neurology, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China.

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关键词： Head‑and‑neck imaging neurology stroke ultrasound vascular surgery

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In patients undergoing endovascular thrombectomy (EVT) with acute ischemic stroke (AIS), dynamic cerebral autoregulation (dCA) may minimize neurological injury from blood pressure fluctuations. This study set out to investigate the function of dCA in predicting clinical outcomes following EVT.43 AIS of the middle cerebral or internal carotid artery patients underwent with EVT, and 43 healthy individuals (controls) were enrolled in this case control research. The dCA was evaluated using transcranial Doppler 12 h and five days after EVT. The transfer function analysis was used to derive the dCA parameters, such as phase, gain, and coherence. The modified Rankin scale (mRS) at 3 months after EVT was used to assess the clinical outcomes. Thefavorable outcome group was defined with mRS ≤2 and the unfavorable outcome group was defined with mRS score of 3-6. Logistic regression analysis was performed to determine the risk factors of clinical outcomes.A significant impairment in dCA was observed on the ipsilateral side after EVT, particularly in patients with unfavorable outcomes. After 5 days, the ipsilateral phase was associated with poor functional outcomes (adjusted odds ratio [OR] = 0.911, 95% confidence interval [CI]: 0.854-0.972; P = 0.005) and the area under the curve (AUC) (AUC, 0.878, [95% CI: 0.756-1.000] P < 0.001) (optimal cutoff, 35.0°). Phase change was an independent predictor of clinical outcomes from 12 h to 5 days after EVT (adjusted OR = 1.061, 95% CI: 1.016-1.109, P = 0.008).dCA is impaired in patients with AIS after EVT. Change in dCA could be an independent factor related to the clinical outcomes.Copyright: © 2024 Brain Circulation.

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出版当年[2023]版：

大类 | 4 区医学

小类 | 4 区临床神经病学 4 区神经科学

最新[2023]版：

大类 | 4 区医学

小类 | 4 区临床神经病学 4 区神经科学

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出版当年[2022]版：

无

最新[2023]版：

Q3 CLINICAL NEUROLOGY Q3 NEUROSCIENCES

影响因子： 2.3 最新[2023版] 2.7 最新五年平均 1.9 出版当年[2022版] 0 出版当年五年平均 0 出版前一年[2021版] 2.3 出版后一年[2023版]

第一作者：

第一作者机构： [1]Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China. [2]Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Xicheng, Beijing, China.

通讯作者：

通讯机构： [1]Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China. [2]Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Xicheng, Beijing, China. [3]Department of Neurology, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China. [*1]Department of VascularUltrasound, XuanwuHospital, Capital MedicalUniversity, No. 45,Changchun Street,Xicheng District, Beijing,100053, China [*2]Department of Neurology,Xuanwu Hospital, Capital Medical University, No.45, Changchun Street,Xicheng District,Beijing, 100053, China

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Compromised dynamic cerebral autoregulation is a hemodynamic marker for predicting poor prognosis even with good recanalization after endovascular thrombectomy

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