Influence of renal impairment on neurologic outcomes following mechanical thrombectomy in acute vertebrobasilar stroke
Purpose Renal impairment (RI) has been regarded as a risk factor for unfavorable neurologic outcomes after mechanical thrombectomy (MT) in acute ischemic stroke. However, most of the previous studies were conducted on patients with anterior circulation stroke. Accordingly, the influence of RI on MT...
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| Veröffentlicht in: | Neuroradiology 2022-04, Vol.64 (4), p.807-815 |
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| creator | Rhim, Jong Kook Park, Jeong Jin Ahn, Jun Hyong Kim, Heung Cheol Na, Doyoung Chai, Chung Liang Jeon, Jin Pyeong |
| description | Purpose
Renal impairment (RI) has been regarded as a risk factor for unfavorable neurologic outcomes after mechanical thrombectomy (MT) in acute ischemic stroke. However, most of the previous studies were conducted on patients with anterior circulation stroke. Accordingly, the influence of RI on MT outcomes has not been well elucidated in detail in acute vertebrobasilar stroke.
Methods
Consecutive stroke patients with MT due to acute vertebrobasilar artery occlusion between March 2015 and December 2020 at four institutions were included. Multivariable logistic regression analysis was conducted to assess the associations between RI and outcomes and mortality at 3 months, and the development of intracerebral hemorrhage (ICH) after the procedure. Additionally, the multivariable Cox proportional hazards model was performed to determine the influence of RI on survival probability after patient discharge.
Results
A total of 110 patients were included in the final analysis. The presence of RI (OR = 0.268, 95% CI: 0.077–0.935), National Institute of Health Stroke Scale scores (OR = 0.849, 95% CI: 0.791–0.910), and puncture-to-recanalization time (OR = 0.981, 95% CI: 0.966–0.997) were related to outcomes. There was no significant association between RI and 3-month mortality or ICH. The cumulative survival probability after adjusting for relevant risk factors demonstrated that RI remained significantly associated with poorer survival after MT compared to patients without RI (HR = 2.111, 95% CI: 0.919–4.847).
Conclusion
RI was an independent risk factor for poor 3-month neurologic outcomes and survival probability after MT in patients with acute vertebrobasilar stroke. |
| doi_str_mv | 10.1007/s00234-021-02838-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2583442668</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2637586016</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-cbba0d8454442306f454397c0fa88c350d3ad68155872b2e0e91ddc39a53b9263</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhonR2NvqH3BhSNy4GT3ADMMsTVO1SRM3uiYMc-aWyscVmDb991Jv1cSFCwLJed4HwkvIKwbvGMD4vgBw0XfAWVtKqA6ekB3rBe_YxOEp2bW56sTUwwk5LeUGAMQoxufkRPRSDlxOO3J7GVe_YbRI00ozRuOpCwfjcsBYaYo04paTT3tnadqqTQELXZP36c7FPQ1or010tsXqdU5hRltTuKcuUmO3ivQWc8U5p9kU502mpeb0HV-QZ6vxBV8-7mfk28eLr-efu6svny7PP1x1VoxD7ew8G1hUP_R9zwXItZ3ENFpYjVJWDLAIs0jFhkGNfOYIOLFlsWIyg5gnLsUZeXv0HnL6sWGpOrhi0XsTMW1F80GJppZSNfTNP-hN2nL7j0bJ9holgT0I-ZGyOZWScdWH7ILJ95qBfmhFH1vRrRX9qxUNLfT6Ub3NAZc_kd81NEAcgdJGcY_5793_0f4EL2eZOw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2637586016</pqid></control><display><type>article</type><title>Influence of renal impairment on neurologic outcomes following mechanical thrombectomy in acute vertebrobasilar stroke</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Rhim, Jong Kook ; Park, Jeong Jin ; Ahn, Jun Hyong ; Kim, Heung Cheol ; Na, Doyoung ; Chai, Chung Liang ; Jeon, Jin Pyeong</creator><creatorcontrib>Rhim, Jong Kook ; Park, Jeong Jin ; Ahn, Jun Hyong ; Kim, Heung Cheol ; Na, Doyoung ; Chai, Chung Liang ; Jeon, Jin Pyeong</creatorcontrib><description>Purpose
Renal impairment (RI) has been regarded as a risk factor for unfavorable neurologic outcomes after mechanical thrombectomy (MT) in acute ischemic stroke. However, most of the previous studies were conducted on patients with anterior circulation stroke. Accordingly, the influence of RI on MT outcomes has not been well elucidated in detail in acute vertebrobasilar stroke.
Methods
Consecutive stroke patients with MT due to acute vertebrobasilar artery occlusion between March 2015 and December 2020 at four institutions were included. Multivariable logistic regression analysis was conducted to assess the associations between RI and outcomes and mortality at 3 months, and the development of intracerebral hemorrhage (ICH) after the procedure. Additionally, the multivariable Cox proportional hazards model was performed to determine the influence of RI on survival probability after patient discharge.
Results
A total of 110 patients were included in the final analysis. The presence of RI (OR = 0.268, 95% CI: 0.077–0.935), National Institute of Health Stroke Scale scores (OR = 0.849, 95% CI: 0.791–0.910), and puncture-to-recanalization time (OR = 0.981, 95% CI: 0.966–0.997) were related to outcomes. There was no significant association between RI and 3-month mortality or ICH. The cumulative survival probability after adjusting for relevant risk factors demonstrated that RI remained significantly associated with poorer survival after MT compared to patients without RI (HR = 2.111, 95% CI: 0.919–4.847).
Conclusion
RI was an independent risk factor for poor 3-month neurologic outcomes and survival probability after MT in patients with acute vertebrobasilar stroke.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-021-02838-0</identifier><identifier>PMID: 34665269</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cerebral Hemorrhage - etiology ; Hemorrhage ; Humans ; Imaging ; Impairment ; Interventional Neuroradiology ; Ischemia ; Ischemic Stroke ; Medicine ; Medicine & Public Health ; Mortality ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Occlusion ; Radiology ; Regression analysis ; Renal function ; Retrospective Studies ; Risk analysis ; Risk factors ; Statistical analysis ; Statistical models ; Stroke ; Stroke - complications ; Stroke - diagnostic imaging ; Stroke - surgery ; Survival ; Thrombectomy - methods ; Treatment Outcome ; Vertebrobasilar Insufficiency - diagnostic imaging ; Vertebrobasilar Insufficiency - surgery</subject><ispartof>Neuroradiology, 2022-04, Vol.64 (4), p.807-815</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-cbba0d8454442306f454397c0fa88c350d3ad68155872b2e0e91ddc39a53b9263</citedby><cites>FETCH-LOGICAL-c375t-cbba0d8454442306f454397c0fa88c350d3ad68155872b2e0e91ddc39a53b9263</cites><orcidid>0000-0001-8543-6855</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00234-021-02838-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-021-02838-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34665269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rhim, Jong Kook</creatorcontrib><creatorcontrib>Park, Jeong Jin</creatorcontrib><creatorcontrib>Ahn, Jun Hyong</creatorcontrib><creatorcontrib>Kim, Heung Cheol</creatorcontrib><creatorcontrib>Na, Doyoung</creatorcontrib><creatorcontrib>Chai, Chung Liang</creatorcontrib><creatorcontrib>Jeon, Jin Pyeong</creatorcontrib><title>Influence of renal impairment on neurologic outcomes following mechanical thrombectomy in acute vertebrobasilar stroke</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Purpose
Renal impairment (RI) has been regarded as a risk factor for unfavorable neurologic outcomes after mechanical thrombectomy (MT) in acute ischemic stroke. However, most of the previous studies were conducted on patients with anterior circulation stroke. Accordingly, the influence of RI on MT outcomes has not been well elucidated in detail in acute vertebrobasilar stroke.
Methods
Consecutive stroke patients with MT due to acute vertebrobasilar artery occlusion between March 2015 and December 2020 at four institutions were included. Multivariable logistic regression analysis was conducted to assess the associations between RI and outcomes and mortality at 3 months, and the development of intracerebral hemorrhage (ICH) after the procedure. Additionally, the multivariable Cox proportional hazards model was performed to determine the influence of RI on survival probability after patient discharge.
Results
A total of 110 patients were included in the final analysis. The presence of RI (OR = 0.268, 95% CI: 0.077–0.935), National Institute of Health Stroke Scale scores (OR = 0.849, 95% CI: 0.791–0.910), and puncture-to-recanalization time (OR = 0.981, 95% CI: 0.966–0.997) were related to outcomes. There was no significant association between RI and 3-month mortality or ICH. The cumulative survival probability after adjusting for relevant risk factors demonstrated that RI remained significantly associated with poorer survival after MT compared to patients without RI (HR = 2.111, 95% CI: 0.919–4.847).
Conclusion
RI was an independent risk factor for poor 3-month neurologic outcomes and survival probability after MT in patients with acute vertebrobasilar stroke.</description><subject>Cerebral Hemorrhage - etiology</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Imaging</subject><subject>Impairment</subject><subject>Interventional Neuroradiology</subject><subject>Ischemia</subject><subject>Ischemic Stroke</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Occlusion</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Renal function</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Statistical models</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - surgery</subject><subject>Survival</subject><subject>Thrombectomy - methods</subject><subject>Treatment Outcome</subject><subject>Vertebrobasilar Insufficiency - diagnostic imaging</subject><subject>Vertebrobasilar Insufficiency - surgery</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU1vFSEUhonR2NvqH3BhSNy4GT3ADMMsTVO1SRM3uiYMc-aWyscVmDb991Jv1cSFCwLJed4HwkvIKwbvGMD4vgBw0XfAWVtKqA6ekB3rBe_YxOEp2bW56sTUwwk5LeUGAMQoxufkRPRSDlxOO3J7GVe_YbRI00ozRuOpCwfjcsBYaYo04paTT3tnadqqTQELXZP36c7FPQ1or010tsXqdU5hRltTuKcuUmO3ivQWc8U5p9kU502mpeb0HV-QZ6vxBV8-7mfk28eLr-efu6svny7PP1x1VoxD7ew8G1hUP_R9zwXItZ3ENFpYjVJWDLAIs0jFhkGNfOYIOLFlsWIyg5gnLsUZeXv0HnL6sWGpOrhi0XsTMW1F80GJppZSNfTNP-hN2nL7j0bJ9holgT0I-ZGyOZWScdWH7ILJ95qBfmhFH1vRrRX9qxUNLfT6Ub3NAZc_kd81NEAcgdJGcY_5793_0f4EL2eZOw</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Rhim, Jong Kook</creator><creator>Park, Jeong Jin</creator><creator>Ahn, Jun Hyong</creator><creator>Kim, Heung Cheol</creator><creator>Na, Doyoung</creator><creator>Chai, Chung Liang</creator><creator>Jeon, Jin Pyeong</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8543-6855</orcidid></search><sort><creationdate>20220401</creationdate><title>Influence of renal impairment on neurologic outcomes following mechanical thrombectomy in acute vertebrobasilar stroke</title><author>Rhim, Jong Kook ; Park, Jeong Jin ; Ahn, Jun Hyong ; Kim, Heung Cheol ; Na, Doyoung ; Chai, Chung Liang ; Jeon, Jin Pyeong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-cbba0d8454442306f454397c0fa88c350d3ad68155872b2e0e91ddc39a53b9263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cerebral Hemorrhage - etiology</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Imaging</topic><topic>Impairment</topic><topic>Interventional Neuroradiology</topic><topic>Ischemia</topic><topic>Ischemic Stroke</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Occlusion</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Renal function</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Statistical models</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - surgery</topic><topic>Survival</topic><topic>Thrombectomy - methods</topic><topic>Treatment Outcome</topic><topic>Vertebrobasilar Insufficiency - diagnostic imaging</topic><topic>Vertebrobasilar Insufficiency - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rhim, Jong Kook</creatorcontrib><creatorcontrib>Park, Jeong Jin</creatorcontrib><creatorcontrib>Ahn, Jun Hyong</creatorcontrib><creatorcontrib>Kim, Heung Cheol</creatorcontrib><creatorcontrib>Na, Doyoung</creatorcontrib><creatorcontrib>Chai, Chung Liang</creatorcontrib><creatorcontrib>Jeon, Jin Pyeong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rhim, Jong Kook</au><au>Park, Jeong Jin</au><au>Ahn, Jun Hyong</au><au>Kim, Heung Cheol</au><au>Na, Doyoung</au><au>Chai, Chung Liang</au><au>Jeon, Jin Pyeong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of renal impairment on neurologic outcomes following mechanical thrombectomy in acute vertebrobasilar stroke</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>64</volume><issue>4</issue><spage>807</spage><epage>815</epage><pages>807-815</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
Renal impairment (RI) has been regarded as a risk factor for unfavorable neurologic outcomes after mechanical thrombectomy (MT) in acute ischemic stroke. However, most of the previous studies were conducted on patients with anterior circulation stroke. Accordingly, the influence of RI on MT outcomes has not been well elucidated in detail in acute vertebrobasilar stroke.
Methods
Consecutive stroke patients with MT due to acute vertebrobasilar artery occlusion between March 2015 and December 2020 at four institutions were included. Multivariable logistic regression analysis was conducted to assess the associations between RI and outcomes and mortality at 3 months, and the development of intracerebral hemorrhage (ICH) after the procedure. Additionally, the multivariable Cox proportional hazards model was performed to determine the influence of RI on survival probability after patient discharge.
Results
A total of 110 patients were included in the final analysis. The presence of RI (OR = 0.268, 95% CI: 0.077–0.935), National Institute of Health Stroke Scale scores (OR = 0.849, 95% CI: 0.791–0.910), and puncture-to-recanalization time (OR = 0.981, 95% CI: 0.966–0.997) were related to outcomes. There was no significant association between RI and 3-month mortality or ICH. The cumulative survival probability after adjusting for relevant risk factors demonstrated that RI remained significantly associated with poorer survival after MT compared to patients without RI (HR = 2.111, 95% CI: 0.919–4.847).
Conclusion
RI was an independent risk factor for poor 3-month neurologic outcomes and survival probability after MT in patients with acute vertebrobasilar stroke.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34665269</pmid><doi>10.1007/s00234-021-02838-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8543-6855</orcidid></addata></record> |
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| ispartof | Neuroradiology, 2022-04, Vol.64 (4), p.807-815 |
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| subjects | Cerebral Hemorrhage - etiology Hemorrhage Humans Imaging Impairment Interventional Neuroradiology Ischemia Ischemic Stroke Medicine Medicine & Public Health Mortality Neurology Neuroradiology Neurosciences Neurosurgery Occlusion Radiology Regression analysis Renal function Retrospective Studies Risk analysis Risk factors Statistical analysis Statistical models Stroke Stroke - complications Stroke - diagnostic imaging Stroke - surgery Survival Thrombectomy - methods Treatment Outcome Vertebrobasilar Insufficiency - diagnostic imaging Vertebrobasilar Insufficiency - surgery |
| title | Influence of renal impairment on neurologic outcomes following mechanical thrombectomy in acute vertebrobasilar stroke |
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