Predicting clinical outcome in posterior circulation large-vessel occlusion patients with endovascular recanalisation: the GNC score

预测接受血管内再通治疗的后循环大血管闭塞患者的临床结局：GNC评分

Acute ischaemic strokes caused by posterior circulation large-vessel occlusions (pc-LVOs) are associated with particularly poor prognoses, including significant disability and mortality rates. This study sought to develop and validate a novel scoring system for predicting functional outcomes in pc-LVO cases following successful endovascular recanalisation. This is the first report that CCT based on DSA is an independent prognostic marker in pc-LVO patients with successful recanalisation post-endovascular treatment. The GNC score, incorporating readily available clinical and angiographic parameters, offers a reliable tool for outcome prediction in this high-risk population.

由后循环大血管闭塞（pc-LVO）导致的急性缺血性卒中与特别差的预后相关，包括显著的残疾率和死亡率。本研究旨在开发并验证一种新的评分系统，用于预测pc-LVO病例血管内再通成功后的功能结局。这是首篇报告指出基于数字减影血管造影（DSA）的CT灌注成像（CCT）是血管内治疗后再通成功的pc-LVO患者的独立预后标志物。GNC评分纳入了容易获取的临床和血管造影参数，为这一高危人群的结局预测提供了可靠的工具。

REF: Wang JQ, Qiu SQ, Li W, Qiu J, Nguyen T, Chen HS. Predicting clinical outcome in posterior circulation large-vessel occlusion patients with endovascular recanalisation: the GNC score. Stroke Vasc Neurol. Published online April 30, 2025. doi:10.1136/svn-2025-004131 PMID: 40312063

Comparing the effectiveness and safety of rescue balloon angioplasty versus stenting in acute large vessel occlusion after thrombectomy

比较血栓切除术后抢救性球囊血管成形术与支架置入术治疗急性大血管闭塞的有效性和安全性

Intracranial atherosclerotic stenosis (ICAS) is a leading cause of failed mechanical thrombectomy (MT). To achieve successful recanalisation, rescue strategies such as balloon angioplasty and stenting are frequently employed. In this study, we aimed to investigate the comparative efficacy and safety of these strategies. Balloon angioplasty after MT may improve clinical outcomes to some extent in ICAS-related LVO with a lower incidence of intracranial haemorrhage compared with stenting, while stenting is an effective measure to prevent long-term restenosis.

颅内动脉粥样硬化性狭窄（ICAS）是机械取栓术（MT）失败的主要原因。为实现成功再通，常采用球囊血管成形术和支架置入术等补救策略。在本研究中，我们旨在探讨这些策略的疗效和安全性对比情况。与支架置入术相比，MT 后进行球囊血管成形术在一定程度上可改善 ICAS 相关的大血管闭塞（LVO）患者的临床结局，且颅内出血发生率更低，而支架置入术是预防长期再狭窄的有效措施。

REF: Jiang Y, Li C, Shi M, et al. Comparing the effectiveness and safety of rescue balloon angioplasty versus stenting in acute large vessel occlusion after thrombectomy. Stroke Vasc Neurol. Published online April 30, 2025. doi:10.1136/svn-2024-003851 PMID: 40312064

Prognostic significance of contrast staining following mechanical thrombectomy in acute ischaemic stroke

急性缺血性卒中机械取栓术后造影剂染色的预后意义

Advances in endovascular thrombectomy (EVT) and extended treatment criteria have improved outcomes in acute ischaemic stroke (AIS). However, contrast staining (CS) on postoperative CT complicates clinical decision-making and outcome evaluation. We investigated the association between postoperative CS and 90-day clinical outcomes in AIS patients. In around half of AIS patients with EVT, CS can be observed and independently associate with poor clinical outcomes, primarily related to the location and density of CS.

血管内取栓术（EVT）的进展以及扩大的治疗标准改善了急性缺血性卒中（AIS）的预后。然而，术后 CT 上的造影剂染色（CS）使临床决策和预后评估变得复杂。我们研究了 AIS 患者术后 CS 与 90 天临床预后之间的关联。在接受 EVT 的 AIS 患者中，约半数可观察到 CS，且 CS 与不良临床预后独立相关，这主要与 CS 的位置和密度有关。

REF: Yan J, Xu X, Li H, et al. Prognostic significance of contrast staining following mechanical thrombectomy in acute ischaemic stroke. Stroke Vasc Neurol. Published online April 30, 2025. doi:10.1136/svn-2025-004113 PMID: 40312062

Effectiveness of intravenous recombinant plasminogen activator treatment in Chinese patients with acute ischaemic stroke aged over 80 years: a retrospective cohort study

静脉注射重组组织型纤溶酶原激活剂治疗80岁以上中国急性缺血性脑卒中患者的有效性：一项回顾性队列研究

Risks and benefits of intravenous recombinant tissue plasminogen activator (rt-PA) remain unclear among elderly patients with acute ischaemic stroke (AIS). This study investigated 1-year clinical outcomes of intravenous rt-PA treatment in Chinese patients aged >80 years with AIS. This study provided real-world evidence for a positive benefit-risk profile of intravenous rt-PA in Chinese patients with AIS aged >80 years.

对于急性缺血性卒中（AIS）老年患者而言，静脉注射重组组织型纤溶酶原激活剂（rt - PA）的风险和获益仍不明确。本研究探讨了年龄大于80岁的中国AIS患者接受静脉注射rt - PA治疗的1年临床结局。本研究为年龄大于80岁的中国AIS患者静脉注射rt - PA的获益 - 风险比呈正向提供了真实世界证据。

REF: Yang J, Huang YH, Zhong W, et al. Effectiveness of intravenous recombinant plasminogen activator treatment in Chinese patients with acute ischaemic stroke aged over 80 years: a retrospective cohort study. Stroke Vasc Neurol. Published online April 30, 2025. doi:10.1136/svn-2024-004004 PMID: 40312065

Efficacy of immediate anti-hypertensive treatment in patients with acute ischaemic stroke stratified by mean arterial pressure and pulse pressure: a secondary analysis of the China Antihypertensive Trial in Acute Ischemic Stroke trial

按平均动脉压和脉压分层的急性缺血性脑卒中患者即刻降压治疗的疗效：中国急性缺血性脑卒中降压试验的一项二次分析

Whether mean arterial pressure (MAP) and pulse pressure (PP), two indicators of cerebral perfusion, could guide the selection of anti-hypertensive strategies after acute ischaemic stroke remains uncertain. Our study was to explore the impact of early anti-hypertensive intervention on adverse clinical outcomes following ischaemic stroke stratified by the levels of MAP and PP based on the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Early anti-hypertensive therapy neither decreased nor increased the odds of major disability, mortality, recurrent stroke or vascular events in patients with acute ischaemic stroke regardless of different MAP and PP levels.

平均动脉压（MAP）和脉压（PP）这两个脑灌注指标能否指导急性缺血性卒中后降压策略的选择仍不确定。我们的研究旨在基于中国急性缺血性卒中降压试验（CATIS），探讨根据MAP和PP水平分层后，早期降压干预对缺血性卒中后不良临床结局的影响。无论MAP和PP水平如何，早期降压治疗既不会降低也不会增加急性缺血性卒中患者发生严重残疾、死亡、复发性卒中或血管事件的几率。

REF: Wang M, Zhu S, Long J, et al. Efficacy of immediate anti-hypertensive treatment in patients with acute ischaemic stroke stratified by mean arterial pressure and pulse pressure: a secondary analysis of the China Antihypertensive Trial in Acute Ischemic Stroke trial. Stroke Vasc Neurol. Published online April 23, 2025. doi:10.1136/svn-2024-003896 PMID: 40268338

Peripheral blood GATA2 expression impacts RNF213 mutation penetrance and clinical severity in moyamoya disease

外周血GATA2表达影响烟雾病中RNF213基因突变外显率和临床严重程度

The p.R4810K founder mutation in the RNF213 gene confers susceptibility to moyamoya disease (MMD) and non-MMD intracranial artery disease. However, penetrance is incomplete, and the underlying molecular mechanism remains unknown. Peripheral blood GATA2 expression was associated with increased penetrance of the RNF213 mutation and more severe clinical manifestations in MMD.

RNF213基因中的p.R4810K奠基者突变会使人易患烟雾病（MMD）和非烟雾病性颅内动脉疾病。然而，该突变的外显率不完全，其潜在的分子机制仍不清楚。外周血GATA2表达与RNF213突变外显率增加以及烟雾病更严重的临床表现相关。

REF: Mineharu Y, Kamata T, Tomoto M, et al. Peripheral blood GATA2 expression impacts RNF213 mutation penetrance and clinical severity in moyamoya disease. Stroke Vasc Neurol. Published online April 23, 2025. doi:10.1136/svn-2024-003970 PMID: 40268337

Impact of socioeconomic deprivation on mechanical thrombectomy outcomes after acute ischaemic stroke: findings from a London-based multicentre study

社会经济剥夺对急性缺血性中风后机械取栓治疗结局的影响：一项基于伦敦的多中心研究结果

Mechanical thrombectomy (MT) improves outcomes in patients who had an acute ischaemic stroke due to large vessel occlusion (LVO). However, socioeconomic status (SES) can influence recovery and prognosis. This study investigated the effect of SES, assessed via the Index of Multiple Deprivation (IMD), on MT outcomes in a multicentre London cohort. Lower SES correlates with worse outcomes and higher complications post-MT, even within a universal healthcare system. Addressing SES disparities could improve stroke care equity.

机械取栓术（MT）可改善因大血管闭塞（LVO）导致急性缺血性中风患者的预后。然而，社会经济地位（SES）会影响患者的恢复和预后。本研究通过多重剥夺指数（IMD）评估社会经济地位，探讨其对伦敦多中心队列中机械取栓术预后的影响。即便在全民医疗体系下，较低的社会经济地位仍与机械取栓术后更差的预后和更高的并发症发生率相关。解决社会经济地位差异问题有助于提高中风治疗的公平性。

REF: D'Anna L, Banerjee S, Levee V, et al. Impact of socioeconomic deprivation on mechanical thrombectomy outcomes after acute ischaemic stroke: findings from a London-based multicentre study. Stroke Vasc Neurol. Published online April 23, 2025. doi:10.1136/svn-2024-003915 PMID: 40268339

Effect of intravenous alteplase before endovascular therapy for atherothrombotic stroke-related large vessel occlusion: subanalysis of the RESCUE AT-LVO registry

血管内治疗前静脉注射阿替普酶对动脉粥样硬化血栓形成性卒中相关大血管闭塞的影响：RESCUE AT - LVO注册研究的亚组分析

Whether intravenous thrombolysis (IVT) should be administered prior to endovascular therapy (EVT) in patients with atherothrombotic stroke-related large vessel occlusion (AT-LVO) remains unclear. This study aimed to assess the efficacy and safety of IVT administered before EVT in this patient population. In patients with AT-LVO, IVT before EVT did not improve outcomes and was associated with increased risk of ICH and mortality in those with in situ intracranial occlusion. IVT before EVT may not be recommended in patients with atherosclerotic intracranial occlusions.

对于动脉粥样硬化血栓形成性卒中相关的大血管闭塞（AT - LVO）患者，在血管内治疗（EVT）前是否应进行静脉溶栓治疗（IVT）仍不清楚。本研究旨在评估该类患者在接受EVT前进行IVT的有效性和安全性。对于AT - LVO患者，在EVT前进行IVT并不能改善预后，且与原位颅内血管闭塞患者的颅内出血（ICH）风险增加和死亡率升高相关。对于动脉粥样硬化性颅内血管闭塞患者，可能不建议在EVT前进行IVT。

REF: Hayashi H, Namitome S, Shindo S, et al. Effect of intravenous alteplase before endovascular therapy for atherothrombotic stroke-related large vessel occlusion: subanalysis of the RESCUE AT-LVO registry. Stroke Vasc Neurol. Published online April 18, 2025. doi:10.1136/svn-2024-003983 PMID: 40250865

Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy

脑出血的侧别及其与情绪和疼痛的关联：MISTIE III 亚组研究

The prognostic significance of the affected hemisphere in haemorrhagic stroke remains uncertain. We aimed to determine the relationship between the affected hemisphere (right or left) and differences in non-motor outcomes, including mood and pain, in patients with acute, supratentorial intracerebral haemorrhage (ICH). These non-motor outcomes are often overlooked in studies following ICH but impact patient recovery and well-being. Right hemispheric lesions were associated with increased reports of mood-related symptoms (depression, anxiety) and pain in patients with acute ICH over time.

出血性卒中中受累半球的预后意义仍不确定。我们旨在确定急性幕上脑出血（ICH）患者的受累半球（右侧或左侧）与非运动结局（包括情绪和疼痛）差异之间的关系。在脑出血后的研究中，这些非运动结局往往被忽视，但它们会影响患者的康复和健康状况。随着时间的推移，急性脑出血患者右侧半球病变与情绪相关症状（抑郁、焦虑）和疼痛报告增加有关。

REF: Cooper DC, Abramson E, Ziai WC, et al. Intracerebral haemorrhage laterality and associations with mood and pain: a MISTIE III substudy. Stroke Vasc Neurol. Published online April 18, 2025. doi:10.1136/svn-2024-003755 PMID: 40250866