Correlation between capillary index score and outcome of endovascular treatment for acute anterior circulation ischemic stroke

Abstract

Objective To investigate the capillary index score (CIS) and clinical outcome after endovascular treatment in patients with anterior circulation acute ischemic stroke (AIS). Methods From March 2014 to March 2017, patients with anterior circulation AIS received endovascular treatment in Jinling Hospital and Wuhu Yijishan Hospital were enrolled retrospectively. The data of intraoperative digital subtraction angiography were collected and CIS was calculated. They were divided into either a poor CIS group (score 0-1) or a good CIS group (scores 2-3). Univariate analysis was used to compare the baseline data, clinical data, and outcomes between the 2 groups. Multivariate logistic regression analysis was used to determine the correlation between CIS and symptomatic intracerebral hemorrhage (sICH), death, and functional outcome at 90 d after endovascular treatment (modified Rankin Scale score 0 to 2 was defined as good outcome). Results A total of 157 patients were enrolled, including 91 (58.0%) had poor CIS and 66 (42.0%) had good CIS. Age (P=0.020), baseline systolic pressure (P=0.014), baseline National Institutes of Health Stroke Scale score (P=0.011), early infarct size (P 3 times (P=0.042) of the poor CIS group were significantly higher than those of the good CIS group. The vascular successful recanalization rate (P<0.001) and good outcome rate (P<0.001) at 90 d in the good CIS group were significantly higher than those in the poor CIS group, while the incidence of sICH (P=0.002) and mortality (P<0.001) were significantly lower than those of the poor CIS group. Multivariate logistic regression analysis showed that CIS were significantly correlated with the functional outcome at 90 d (odd ratio [OR] 0.581, 95% confidence interval [CI] 0.419-0.805; P=0.001) and the risk of sICH at 72 h (OR 0.611, 95% CI 0.407-0.919; P=0.018) after endovascular treatment in patients with anterior circulation AIS, but it did not have a significant correlation with the risk of death (OR 0.783, 95% CI 0.492-1.246; P=0.301). Conclusions CIS was significantly correlated with the clinical outcome in patients with anterior circulation AIS after endovascular treatment. It can be used as a tool to select patients for endovascular treatment. Key words: Stroke; Brain Ischemia; Capillaries; Collateral Circulation; Cerebral Angiography; Thrombectomy; Endovascular Procedures; Treatment Outcome