Effectiveness and safety of endovascular thrombectomy for large versus medium vessel occlusions: a single-center experience

被引：13

作者：

Shek, Kevin ^{[1
]}

Alcock, Susan ^{[2
]}

Ghrooda, Esseddeeg ^{[3
]}

Trivedi, Anurag ^{[3
]}

McEachern, James ^{[2
]}

Kaderali, Zul ^{[4
]}

Shankar, Jai ^{[2
]}

机构：

[1] Univ Manitoba, Radiol, Max Rady Coll Med, Winnipeg, MB, Canada

[2] Univ Manitoba, Radiol, Fac Hlth Sci, Winnipeg, MB R3E 3P5, Canada

[3] Univ Manitoba, Sect Neurol, Internal Med, Fac Hlth Sci, Winnipeg, MB, Canada

[4] Univ Manitoba, Sect Neurosurg, Surg, Fac Hlth Sci, Winnipeg, MB, Canada

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2022年 / 14卷 / 05期

关键词：

CT; CT angiography; thrombectomy; stroke; ACUTE ISCHEMIC-STROKE; MECHANICAL THROMBECTOMY; INTRAVENOUS ALTEPLASE; THERAPY; TRIAL;

D O I：

10.1136/neurintsurg-2021-017502

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Background The effectiveness and safety of endovascular thrombectomy (EVT) for medium vessel occlusions (MeVO) in the anterior intracranial circulation for patients with acute ischemic stroke (AIS) has yet to be definitively established. We compared outcomes in patients undergoing EVT for large vessel occlusion (LVO) versus those with MeVO. Methods This retrospective cohort study, using an intention to treat design, compared the 90-day modified Rankin Scale (mRS) score between 43 patients with MeVO and 199 with LVO in the anterior intracranial circulation. Secondary outcome measures included vessel recanalization using the Thrombolysis in Cerebral Infarction (TICI) score, procedural complications, post-EVT intracranial hemorrhage (ICH), and infarct size. Results The rate of good functional outcome (90-day mRS 0-2) was higher in patients with LVO than in those with MeVO (32.9% vs 27%), but this was not statistically significant (p=0.19). The rate of EVT procedural complications was also not significantly different between the groups (p=0.10), nor was the rate of ICH (p=0.30). There was also no significant difference in TICI scores between groups (p=0.12). Infarct size was larger in the LVO group (p<0.01). Multivariate analysis showed older age, not receiving recombinant tissue plasminogen activator (r-tPA), and larger infarct size were independent predictors of poor functional outcome at 90 days. Conclusion The 90-day mRS and rate of periprocedural complications were not significantly different between patients treated for LVO and those treated for MeVO with EVT. Older age, not receiving r-tPA, and larger infarct size were independent predictors of poor outcome at 90 days.

引用

页码：434 / +

页数：6

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