Efficacy and Safety of Mechanical Thrombectomy for Acute Mild Ischemic Stroke with Large Vessel Occlusion
Autor: | Gui-Fang Wang, Shu-Ping Liu, Xue Zhao, Zu-Neng Lu, Yi-Lei Xiao |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Mechanical Thrombolysis medicine.medical_treatment 030204 cardiovascular system & hematology Brain Ischemia 03 medical and health sciences Dental Occlusion Balanced 0302 clinical medicine Fibrinolytic Agents Clinical Research Risk Factors Modified Rankin Scale Internal medicine medicine Humans Thrombolytic Therapy cardiovascular diseases Aged Ischemic Stroke Thrombectomy Aged 80 and over business.industry Mortality rate Incidence (epidemiology) General Medicine Thrombolysis Middle Aged Stroke Mechanical thrombectomy Treatment Outcome Blood pressure Tissue Plasminogen Activator 030220 oncology & carcinogenesis Ischemic stroke Cardiology Administration Intravenous Female business Large vessel occlusion |
Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
ISSN: | 1643-3750 |
Popis: | BACKGROUND The suitability of mechanical thrombectomy (MT) for patients with acute mild ischemic stroke (AMIS) caused by large vessel occlusion (LVO) is controversial. This study evaluated MT in patients with AMIS and LVO. MATERIAL AND METHODS Forty-seven patients diagnosed as AMIS with LVO received MT or intravenous thrombolysis (IVT). Primary outcomes were National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale scores. Secondary outcomes were incidence of systemic complications and symptomatic intracranial hemorrhage. RESULTS There were no significant differences between IVT and MT groups for gender, age, risk factors of cerebrovascular disease, past history, NIHSS score at admission, blood pressure, and LVO sites. For all patients, the NIHSS scores at discharge were lower than those at admission. Patients with excellent outcomes were 66.6% (16/24) in the IVT group and 60.8% (14/23) in the MT group; favorable outcome rates were 75% (18/24) in the IVT group and 69.6% (16/23) in the MT group, with no significant differences between groups. Twelve patients (52.2%) in the MT group and 5 (20.8%) in the IVT group had systemic complications. Symptomatic intracranial hemorrhage was not detected in the IVT group, but manifested in 2 (8.7%) patients in the MT group. During 90-day follow-up, 1 patient died in each of the IVT and MT groups, with 4.2% and 4.4% mortality rates, respectively. CONCLUSIONS The efficacy of MT and IVT was comparable in AMIS patients with LVO. While MT had a higher incidence of systemic complications, its short- and long-term effects were equivalent to IVT. |
Databáze: | OpenAIRE |
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