Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation
Objective To investigate the efficacy and safety of mechanical thrombectomy in patients with acute progressive ischemic stroke with large vessel occlusion in the anterior circulation. Methods From January 2020 to April 2023, 414 patients with acute progressive ischemic stroke with large vessel occlu...
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Tianjin Huanhu Hospital
2024-11-01
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| Series: | Chinese Journal of Contemporary Neurology and Neurosurgery |
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| Online Access: | http://www.cjcnn.org/index.php/cjcnn/article/view/2949 |
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| author | HAN Ning ZHAO Yan MA Liang WANG He⁃bo XU Guo⁃dong |
| author_facet | HAN Ning ZHAO Yan MA Liang WANG He⁃bo XU Guo⁃dong |
| author_sort | HAN Ning |
| collection | DOAJ |
| description | Objective To investigate the efficacy and safety of mechanical thrombectomy in patients with acute progressive ischemic stroke with large vessel occlusion in the anterior circulation. Methods From January 2020 to April 2023, 414 patients with acute progressive ischemic stroke with large vessel occlusion in the anterior cirulation in Hebei General Hospital were included. According to the time of onset and whether the patients underwent mechanical thrombectomy, the patients were divided into direct mechanical thrombectomy group (n = 293), progressive stroke mechanical thrombectomy group (n =45), and standard medical treatment group (n = 76). The modified Rankin Scale (mRS) and modified Thrombolysis in Cerebral Infarction (mTICI) were used to evaluate neurological prognosis and vascular recanalization. The incidence of symptomatic intracranial hemorrhage after treatment and 3⁃month all⁃cause mortality were recorded. Results There was a statistically significant difference in neurological prognosis among the 3 groups (χ2 = 19.572, P = 0.000). The rate of good prognosis in standard medical treatment
group was lower than that progressive stroke mechanical thrombectomy group (Z = ⁃ 2.829, P = 0.005) and direct mechanical thrombectomy group (Z = ⁃ 4.422, P = 0.000), while there was no statistically significant difference in the rate of good prognosis between direct mechanical thrombectomy group and progressive stroke mechanical thrombectomy group (Z = ⁃ 0.525, P = 0.600). Logistic regression analysis showed that high National Institutes of Health Stroke Scale (NIHSS) score before treatment (OR = 1.298, 95%CI: 1.216-
1.385; P = 0.000) and standard medical treatment (OR = 7.572, 95%CI: 3.048-18.809; P = 0.000) were the
risk factors for poor prognosis, and direct mechanical thrombectomy was the protective factor for good prognosis (OR = 0.431, 95%CI: 0.212-0.879; P = 0.021). There was no statistically significant difference in
the vascular recanalization rate between progressive stroke mechanical thrombectomy group and direct mechanical thrombectomy group (χ2 = 0.218, P = 0.640). There was a statistically significant difference in
the incidence of symptomatic intracranial hemorrhage after treatment among the 3 groups (χ2 = 6.575, P = 0.037), and direct mechanical thrombectomy group was higher than that of standard medical treatment group (Z = ⁃ 2.376, P = 0.018). There was no statistically significant difference in the 3⁃month all⁃cause mortality (χ2 = 5.178, P = 0.075). Conclusions Mechanical thrombectomy is feasible in patients with acute progressive ischemic stroke with large vessel occlusion in the anterior circulation, and has a good efficacy and safety. |
| format | Article |
| id | doaj-art-8c4e00b9c7694e22945e4866aef864d8 |
| institution | Kabale University |
| issn | 1672-6731 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Tianjin Huanhu Hospital |
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| series | Chinese Journal of Contemporary Neurology and Neurosurgery |
| spelling | doaj-art-8c4e00b9c7694e22945e4866aef864d82024-12-09T09:37:57ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312024-11-012411906912DOI:10.3969/j.issn.1672⁃6731.2024.11.006Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulationHAN Ning0ZHAO Yan1MA Liang2WANG He⁃bo3XU Guo⁃dong4Department of Neurology; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Hebei General Hospital, Shijiazhuang 050051, Hebei, ChinaDepartment of Neurology; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Hebei General Hospital, Shijiazhuang 050051, Hebei, ChinaDepartment of Neurology; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Hebei General Hospital, Shijiazhuang 050051, Hebei, ChinaDepartment of Neurology; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Hebei General Hospital, Shijiazhuang 050051, Hebei, ChinaDepartment of Neurology; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Hebei General Hospital, Shijiazhuang 050051, Hebei, ChinaObjective To investigate the efficacy and safety of mechanical thrombectomy in patients with acute progressive ischemic stroke with large vessel occlusion in the anterior circulation. Methods From January 2020 to April 2023, 414 patients with acute progressive ischemic stroke with large vessel occlusion in the anterior cirulation in Hebei General Hospital were included. According to the time of onset and whether the patients underwent mechanical thrombectomy, the patients were divided into direct mechanical thrombectomy group (n = 293), progressive stroke mechanical thrombectomy group (n =45), and standard medical treatment group (n = 76). The modified Rankin Scale (mRS) and modified Thrombolysis in Cerebral Infarction (mTICI) were used to evaluate neurological prognosis and vascular recanalization. The incidence of symptomatic intracranial hemorrhage after treatment and 3⁃month all⁃cause mortality were recorded. Results There was a statistically significant difference in neurological prognosis among the 3 groups (χ2 = 19.572, P = 0.000). The rate of good prognosis in standard medical treatment group was lower than that progressive stroke mechanical thrombectomy group (Z = ⁃ 2.829, P = 0.005) and direct mechanical thrombectomy group (Z = ⁃ 4.422, P = 0.000), while there was no statistically significant difference in the rate of good prognosis between direct mechanical thrombectomy group and progressive stroke mechanical thrombectomy group (Z = ⁃ 0.525, P = 0.600). Logistic regression analysis showed that high National Institutes of Health Stroke Scale (NIHSS) score before treatment (OR = 1.298, 95%CI: 1.216- 1.385; P = 0.000) and standard medical treatment (OR = 7.572, 95%CI: 3.048-18.809; P = 0.000) were the risk factors for poor prognosis, and direct mechanical thrombectomy was the protective factor for good prognosis (OR = 0.431, 95%CI: 0.212-0.879; P = 0.021). There was no statistically significant difference in the vascular recanalization rate between progressive stroke mechanical thrombectomy group and direct mechanical thrombectomy group (χ2 = 0.218, P = 0.640). There was a statistically significant difference in the incidence of symptomatic intracranial hemorrhage after treatment among the 3 groups (χ2 = 6.575, P = 0.037), and direct mechanical thrombectomy group was higher than that of standard medical treatment group (Z = ⁃ 2.376, P = 0.018). There was no statistically significant difference in the 3⁃month all⁃cause mortality (χ2 = 5.178, P = 0.075). Conclusions Mechanical thrombectomy is feasible in patients with acute progressive ischemic stroke with large vessel occlusion in the anterior circulation, and has a good efficacy and safety.http://www.cjcnn.org/index.php/cjcnn/article/view/2949ischemic stroke; circle of willis; arterial occlusive diseases; thrombectomy; prognosis; risk factors; logistic models |
| spellingShingle | HAN Ning ZHAO Yan MA Liang WANG He⁃bo XU Guo⁃dong Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation Chinese Journal of Contemporary Neurology and Neurosurgery ischemic stroke; circle of willis; arterial occlusive diseases; thrombectomy; prognosis; risk factors; logistic models |
| title | Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation |
| title_full | Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation |
| title_fullStr | Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation |
| title_full_unstemmed | Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation |
| title_short | Analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation |
| title_sort | analysis of the efficacy of mechanical thrombectomy in acute progressive ischemic stroke with large vessel occlusion in the anterior circulation |
| topic | ischemic stroke; circle of willis; arterial occlusive diseases; thrombectomy; prognosis; risk factors; logistic models |
| url | http://www.cjcnn.org/index.php/cjcnn/article/view/2949 |
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