Endovascular treatment for acute ischaemic stroke caused by isolated internal carotid artery occlusion: treatment strategies, outcomes, and prognostic factors

被引：5

作者：

Ni, H. ^{[1
]}

Zhou, C. ^{[1
]}

Hang, Y. ^{[1
]}

Jia, Z. -Y. ^{[1
]}

Cao, Y. -Z. ^{[1
]}

Shi, H. -B. ^{[1
]}

Liu, S. ^{[1
]}

Zhao, L. -B. ^{[1
]}

机构：

[1] Nanjing Med Univ, Affiliated Hosp 1, Dept Intervent Radiol, 300 Guangzhou Rd, Nanjing 210029, Peoples R China

来源：

CLINICAL RADIOLOGY | 2023年 / 78卷 / 06期

关键词：

INTRAVENOUS THROMBOLYSIS; PROTECTION DEVICES; THERAPY; ANGIOPLASTY; TRIAL; THROMBECTOMY; SAFETY; DEATH; FLOW;

D O I：

10.1016/j.crad.2023.02.010

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

AIM: To describe the experience of endovascular treatment (EVT) of acute ischaemic stroke caused by isolated internal carotid artery (ICA) occlusion, with emphasis on treatment stra-tegies, outcomes, and prognostic factors.MATERIALS AND METHODS: A retrospective examination was performed of 66 consecutive patients with acute moderate-to-severe stroke who underwent EVT for isolated ICA occlusion from July 2016 to June 2021. The modified thrombolysis in cerebral ischaemia (mTICI) score was used to evaluate reperfusion outcomes. A multivariate analysis was performed to identify risk factors associated with poor 90-day outcome (modified Rankin Scale [mRS] 3-6).RESULTS: The National Institutes of Health Stroke Scale (NIHSS) median score of the 66 patients at admission was 15. Twelve patients (18.2%) showed thrombus migration to the M1 segment or proximal M2 during EVT and underwent additional intracranial thrombectomy. Successful reperfusion (mTICI 2b-3) was achieved in 60 patients (90.9%) and complete reperfusion (mTICI 3) in 42 (63.6%). A poor functional outcome was seen in 27 patients (40.9%). The rate of 90-day mortality was 9.1% (6/66). Higher NIHSS scores and a lower Alberta Stroke Program Early CT Score (ASPECTS) were independently associated with poor outcomes. Complete reperfusion was the only treatment factor with a significant predictive value (adjusted odds ratio [OR] 0.03; 95% CI = 0.01 to 0.25; p=0.001).CONCLUSION: Endovascular therapy is safe and effective in patients with acute ischaemic stroke due to isolated ICA occlusion. Prevention of thrombus migration and complete reper-fusion should be the aim of EVT.(c) 2023 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

引用

页码：451 / 458

页数：8

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