Influence of renal impairment on clinical outcomes after endovascular recanalization in vertebrobasilar artery occlusions

• DOI: 10.1136/neurintsurg-2021-018003
• Publication Date: 2021-12-01T18:20:44Z
• Authors: Lulu Xiao; Mengmeng Gu; Yijiu Lu; Pengfei Xu; Jinjing Wang; Wenya Lan; Yong Huang; Guoqiang Xu; Shuanggen Zhu; Qizhang Wang; Wei Hu; Wusheng Zhu; Wen Sun; Xinfeng Liu
• Keywords: Endovascular Procedures; Arterial Occlusive Diseases; Arteries; 3. Good health; Stroke; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Intracranial Hemorrhages; Retrospective Studies; Thrombectomy

BackgroundRenal impairment (RI) is associated with worse outcomes in the treatment of intravenous thrombolysis and emergent endovascular treatment (EVT) in anterior circulation stroke. The objective of this study was to investigate the association of RI with short-term and long-term outcomes in patients with vertebrobasilar artery occlusions (VBAO) who received EVT.MethodsConsecutive patients with VBAO receiving EVT involving 21 stroke centers were retrospectively included. Multivariate regression analyses were used to evaluate the association of RI with mortality and symptomatic intracranial hemorrhage (sICH) during the hospital stay, and also mortality, favorable functional outcome (modified Rankin Scale (mRS) score of 0–3), and functional improvement (shift in mRS score) at 3 months and 1 year follow-up. The association between RI and the risk of recurrent stroke was evaluated with multivariate competing-risk regression analyses.ResultsAfter adjustment for potential confounders, RI was independently associated with sICH (OR 3.30, 95% CI 1.55 to 7.18), as well as mortality (OR 2.54, 95% CI 1.47 to 4.38; OR 3.07, 95% CI 1.72 to 8.08), favorable functional outcome (OR 0.33, 95% CI 0.17 to 0.66; OR 0.25, 95% CI 0.12 to 0.51), and functional improvement (OR 0.45, 95% CI 0.28 to 0.74; OR 0.35, 95% CI 0.21 to 0.60) at 3 months and 1 year follow-up, respectively, but RI was not associated with in-hospital mortality. Additionally, there was no significant association between RI and recurrent stroke within 1 year.ConclusionsOur findings suggest that RI is associated with a higher risk of sICH in hospital and a decrease in survival, favorable functional outcome, and functional improvement at 90 days and 1 year follow-up.Trial registration numberURL:http://www.chictr.org.cn/; Unique identifier: ChiCTR2000033211.