Feasibility and Clinical Outcome Predictors of Mechanical Thrombectomy in Distal Arterial Occlusion Causing Acute Ischemic Stroke: A Monocentric Retrospective Study.

IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY
Beihai Ge, Limei Pan, Huihua Liu
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引用次数: 0

Abstract

Background: The feasibility and clinical outcome predictors of mechanical thrombectomy (MT) for strokes caused by distal arterial occlusion (DAO) remain the subject of debate.

Methods: A retrospective analysis was conducted of patients with consecutive acute ischemic stroke treated using MT. Clinical and procedural-associated factors were studied to compare the efficacy, safety, and short-term and long-term outcomes of MT between the proximal arterial occlusion (PAO) and DAO groups. The predictors of a good functional outcome in the DAO group were also identified.

Results: A total of 116 patients were included in this study, of whom 23 (19.8%) underwent MT for DAO. A higher complete recanalization rate was independently associated with PAO in adjusted models [adjusted odds ratio, 0.596; 95% CI, 0.377-0.941]. The measures of safety and clinical outcome showed no significant differences between the DAO and PAO groups. The National Institute of Health stroke scale (NIHSS) score on admission, hybrid technique use, and complete recanalization rate emerged as independent predictors of a good functional outcome in the DAO group.

Conclusions: The efficacy, safety, and short-term and long-term outcomes of DAO thrombectomy were similar to those of PAO thrombectomy. The good functional outcome predictors of MT in DAO included NIHSS on admission, hybrid technique use, and complete recanalization. Overall, the findings lead us to propose that MT may be considered a feasible option for treating DAO after a careful risk-benefit analysis.

机械取栓治疗远端动脉闭塞引起急性缺血性脑卒中的可行性和临床预后预测:一项单中心回顾性研究。
背景:机械取栓(MT)治疗远端动脉闭塞(DAO)所致脑卒中的可行性和临床预后预测因素仍存在争议。方法:对连续急性缺血性脑卒中患者进行回顾性分析,研究临床和手术相关因素,比较近端动脉闭塞(PAO)组和DAO组MT的疗效、安全性、近期和长期预后。还确定了DAO组良好功能预后的预测因素。结果:本研究共纳入116例患者,其中23例(19.8%)行MT治疗DAO。在校正模型中,较高的完全再通率与PAO独立相关[校正优势比,0.596;95% ci, 0.377-0.941]。安全性和临床结果在DAO组和PAO组之间没有显着差异。美国国立卫生研究院卒中量表(NIHSS)在入院、混合技术使用和完全再通率方面的评分成为DAO组良好功能结局的独立预测因素。结论:DAO取栓术的疗效、安全性、近期和长期预后与PAO取栓术相似。入院时NIHSS、混合技术的使用和完全再通是DAO患者MT功能预后的良好预测指标。总的来说,研究结果使我们提出,经过仔细的风险-收益分析,MT可能被认为是治疗DAO的可行选择。
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来源期刊
Neurologist
Neurologist 医学-临床神经学
CiteScore
1.90
自引率
0.00%
发文量
151
审稿时长
2 months
期刊介绍: The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.
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