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目的:探讨CT血管造影(CT angiography, CTA)区域软脑膜侧支循环(regional leptomeningeal collateral, rLMC)评分对晚时间窗前循环卒中患者血管内治疗后转归的预测价值。方法:回顾性纳入2018年1月至2021年7月在发病后6~24 h内在苏州大学附属第一医院神经内科接受血管内治疗的急性前循环大血管闭塞性卒中患者。在发病后3个月时根据改良Rankin量表进行转归评价，≤2分定义为转归良好，>2分定义为转归不良。收集患者临床资料、非增强CT及CTA参数。应用多变量n logistic分析确定血管内治疗后转归不良的独立影响因素。n 结果:共纳入74例接受血管内治疗的急性前循环大血管闭塞性卒中患者，年龄(64.41±12.98)岁，男性43例(58.1%)，基线美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分(13.18±5.22)分，中位发病至穿刺时间为527.5 min。53例(71.6%)选择直接血栓切除术，21例(28.4%)选择静脉溶栓桥接血栓切除术。转归良好36例(48.6%)，转归不良38例(51.4%)，其中4例(5.4%)死亡。单变量分析表明，转归良好组年龄、心房颤动、空腹血糖、NIHSS评分、阿尔伯塔卒中项目早期CT评分(Alberta Stroke Program Early CT Score, ASPECTS)、rLMC评分以及血栓负荷评分与转归不良组均差异有统计学意义(n P均2 was defined as poor outcome. The clinical data, non-enhanced CT and CTA parameters of the patients were collected. Multivariate n logistic analysis was used to determine the independent influencing factors of poor outcomes after endovascular treatment.n Results:A total of 74 patients with acute anterior circulation large vessel occlusive stroke treated with endovascular treatment in the late window were enrolled. Their age was 64.41±12.98 years, 43 were males (58.1%). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.18±5.22, and the median time from onset to puncture was 527.5 min. Fifty-three patients (71.6%) chose direct thrombectomy and 21 (28.4%) chose intravenous thrombolysis and bridging thrombectomy. Thirty-six patients (48.6%) had a good outcome and 38 (51.4%) had a poor outcome, including 4 (5.4%) died. Univariate analysis showed that there were significant differences in age, atrial fibrillation, fasting blood glucose, NIHSS score, Alberta Stroke Program Early CT Score (ASPECTS), rLMC score and clot burden score between the good outcome group and the poor outcome group (all n P<0.05). Multivariaten logistic regression analysis showed that higher ASPECTS (odds ratio 0.352, 95% confidence interval 0.157-0.791; n P=0.012) and rLMC score (odds ratio 0.550, 95% confidence interval 0.329-0.919; n P=0.022) were the independent predictors of good outcomes after endovascular therapy.n Conclusion:ASPECTS and rLMC scores were the independent predictors of clinical outcomes after endovascular therapy in patients with late window anterior circulation large vessel occlusive stroke. It had certain guiding value for the decision-making of endovascular treatment in such patients.