Effects of mechanical thrombectomy for acute stroke patients with etiology of large artery atherosclerosis

被引：22

作者：

Sun, Bo ^{[1
,2
]}

Shi, Zhonghua ^{[3
]}

Pu, Jie ^{[4
]}

Yang, Shiquan ^{[5
]}

Wang, Huaiming ^{[6
,7
]}

Yang, Dong ^{[6
]}

Hao, Yonggang ^{[4
,8
]}

Lin, Min ^{[9
]}

Ke, Wei ^{[10
]}

Liu, Wenhua ^{[11
]}

Guo, Fuqiang ^{[12
]}

Bai, Yongjie ^{[1
,13
]}

Zhang, Shuai ^{[1
,14
]}

Li, Zibao ^{[1
,15
]}

Li, Shun ^{[4
]}

Zuo, Meng ^{[16
]}

Xu, Gelin ^{[1
]}

Zi, Wenjie ^{[1
]}

Liu, Xinfeng ^{[1
]}

机构：

[1] Nanjing Med Univ, Dept Neurol, Jinling Clin Coll, 305 East Zhongshan Rd, Nanjing 210002, Jiangsu, Peoples R China

[2] Nanjing Med Univ, Huaian Peoples Hosp 1, Dept Neurol, Huaian, Jiangsu, Peoples R China

[3] Peoples Liberat Army, Hosp 101, Dept Neurosurg, Wuxi, Jiangsu, Peoples R China

[4] Southern Med Univ, Jinling Hosp, Dept Neurol, Nanjing, Jiangsu, Peoples R China

[5] Peoples Liberat Army, Hosp 123, Dept Neurol, Bengbu, Anhui, Peoples R China

[6] Second Mil Med Univ, Jinling Hosp, Dept Neurol, Nanjing, Jiangsu, Peoples R China

[7] Peoples Liberat Army, Hosp 89, Dept Neurol, Weifang, Shandong, Peoples R China

[8] Soochow Univ, Affiliated Hosp 1, Dept Emergency Med, Suzhou, Jiangsu, Peoples R China

[9] Fuzhou Gen Hosp Nanjing Mil Reg, Dept Neurol, Fuzhou, Fujian, Peoples R China

[10] Hubei Zhongshan Hosp, Dept Neurol, Wuhan, Hubei, Peoples R China

[11] Wuhan 1 Hosp, Dept Neurol, Wuhan, Hubei, Peoples R China

[12] Sichuan Prov Peoples Hosp, Dept Neurol, Chengdu, Sichuan, Peoples R China

[13] Henan Univ Sci & Technol, Dept Neurol, Affiliated Hosp 1, Coll Clin Med, Luoyang, Henan, Peoples R China

[14] Yangzhou Univ, Affiliated Hosp, Dept Neurol, Yangzhou, Jiangsu, Peoples R China

[15] Wannan Med Coll, Yijishan Hosp, Dept Neurol, Wuhu, Anhui, Peoples R China

[16] Southeast Univ, Med Sch, Dept Neurol, Jinling Hosp, Nanjing, Jiangsu, Peoples R China

来源：

JOURNAL OF THE NEUROLOGICAL SCIENCES | 2019年 / 396卷

基金：

中国国家自然科学基金;

关键词：

Mechanical thrombectomy; Large artery atherosclerosis; Cardioembolism; Acute ischemic stroke; Etiology; ACUTE ISCHEMIC-STROKE; SYMPTOMATIC INTRACRANIAL HEMORRHAGE; ENDOVASCULAR TREATMENT; PREDICTORS; OUTCOMES; THERAPY; CLASSIFICATION; MANAGEMENT; MORTALITY;

D O I：

10.1016/j.jns.2018.10.017

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Aims: Atherosclerosis is more prevalent in Asian population. This distinct etiology of stroke might disadvantage Asian patients when applying. mechanical thrombectomy (MT). The purpose of this research was to evaluate the efficacy and safety of MT in a cohort of Chinese patients with acute ischemic stroke. due to large artery atherosclerosis (LAA). Methods and results: A total of 649 patients treated with MT were included. Patients were classified according to etiology of stroke as LAA and cardioembolism ones. Successful revascularization was defined as modified Thrombolysis in Cerebral Infarction (mTICI) grade >= 2b. Favorable outcome was defined as modified Rankin Scale (mRS) score <= 2 at 90 days. Logistic regression was used to identify predictors for functional outcomes. The patients with stroke of LAA etiology had significantly higher rate of favorable functional outcome (50.2% vs 36.5%, p < .001) and good collateral (grade of ASITN/SIRI: 2-3) (58.8% versus 43.2%, p < .001), and lower median baseline National Institutes of Health Stroke Scale score (NIHSS) (15.6 versus 18.2, p < .001), compared to patients with stroke of cardioembolism etiology. There was no significant difference in the rate of successful postprocedural mTICI between groups (84.5% versus 83.2%, p = .671). Rates of symptomatic intracranial hemorrhage (20.0% versus 11.7%, p = .004) and mortality (31.8% versus 18.8%, p < .001) within 3 months were notably higher in the cardioembolism group than that in the LAA group. Conclusion: Mechanical thrombectomy may be more efficacious in treating acute ischemic stroke of LAA etiology than that of cardioembolism etiology.

引用

页码：178 / 183

页数：6

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