Degree of subarachnoid hemorrhage affects clinical outcome after mechanical thrombectomy for M2 occlusion.

IF 1.7 4区医学 Q3 Medicine

Interventional Neuroradiology Pub Date : 2024-08-07 DOI:10.1177/15910199241270706

Fumiaki Oka, Takuma Nishimoto, Naomasa Mori, Akiko Kawano, Hideyuki Ishihara

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引用次数: 0

Abstract

Purpose: The prognostic relevance of post-mechanical thrombectomy (MT) subarachnoid hemorrhage (SAH) remains controversial. This study aimed to investigate whether the thickness of the SAH clot affects clinical outcomes following MT for M2 occlusion.

Methods: A retrospective analysis was conducted on a prospective database of patients who underwent MT for isolated M2 occlusion. Patients were categorized into three groups based on the presence and thickness of SAH. Clinical and angiographical characteristics and outcomes were compared.

Results: Of the 36 patients included, SAH was observed in 15 (42%). When comparing patients with no SAH (grade 0) or thin SAH (grade 1) (N = 28) with those who had thick SAH (grade 2) (N = 8), patients with Grade 2 SAH required a higher number of passes and had a more severe angulation at M2. Patients with SAH Grade 2 had significantly worse NIHSS scores at 24 h (median, 4 vs. 14), but only one patient was identified as having a symptomatic intracranial hemorrhage. Patients with SAH Grade 2 were found to have a lower rate of favorable outcome (modified Rankin scale 0-2) (23% vs. 75%, P = 0.0026) and higher mortality (25% vs. 0%, P = 0.0499) at 90 days.

Conclusion: The study found that thick SAH prevents clinical recovery after MT for M2 occlusion, even in cases of successful recanalization, and is associated with an unfavorable outcome. Thick SAH after MT is also linked to an increase in the number of passes and severe angulation at the M2 segment.

查看原文本刊更多论文

蛛网膜下腔出血程度影响 M2 闭塞机械取栓术的临床疗效。

目的：机械取栓术（MT）后蛛网膜下腔出血（SAH）的预后相关性仍存在争议。本研究旨在探讨 SAH 血栓的厚度是否会影响 MT 治疗 M2 闭塞后的临床预后：方法：我们对前瞻性数据库中接受MT治疗孤立性M2闭塞的患者进行了回顾性分析。根据 SAH 的存在和厚度将患者分为三组。比较了临床和血管造影特征及结果：在纳入的 36 例患者中，有 15 例（42%）观察到 SAH。将无 SAH（0 级）或 SAH 较薄（1 级）的患者（28 人）与 SAH 较厚（2 级）的患者（8 人）进行比较，2 级 SAH 患者所需的穿刺次数更多，M2 处的成角更严重。2级SAH患者在24小时后的NIHSS评分明显较差（中位数为4分对14分），但只有一名患者被确定为有症状的颅内出血。研究发现，SAH 2级患者的良好预后率（改良Rankin量表0-2）较低（23%对75%，P=0.0026），90天后的死亡率较高（25%对0%，P=0.0499）：研究发现，M2 闭塞的 MT 术后，厚 SAH 会阻碍临床恢复，即使在成功再通的病例中也是如此，并且与不利的预后相关。MT后SAH过厚还与M2段的通过次数增加和严重成角有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology 医学-核医学

CiteScore

2.80

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...