Prognosis and risk factors for reocclusion after mechanical thrombectomy

Autor:	Xunming Ji, Jiayue Ding, Qingfeng Ma, Weili Li, Xueqin Sui, Ke Jian Liu, Longfei Wu, Kangxiang Ji, Zhifeng Qi, Chenghe Sun
Rok vydání:	2020
Předmět:	Male 0301 basic medicine China medicine.medical_specialty Mechanical Thrombolysis medicine.medical_treatment Arterial Occlusive Diseases Neurosciences. Biological psychiatry. Neuropsychiatry 03 medical and health sciences 0302 clinical medicine Risk Factors Modified Rankin Scale Internal medicine Outcome Assessment Health Care medicine Humans RC346-429 Research Articles Aged Ischemic Stroke Retrospective Studies Stroke scale business.industry General Neuroscience Mortality rate Incidence (epidemiology) Thrombolysis Odds ratio Middle Aged Prognosis Confidence interval Mechanical thrombectomy 030104 developmental biology Cardiology Female Neurology. Diseases of the nervous system Neurology (clinical) business 030217 neurology & neurosurgery Research Article RC321-571
Zdroj:	Annals of Clinical and Translational Neurology, Vol 7, Iss 4, Pp 420-428 (2020) Annals of Clinical and Translational Neurology
ISSN:	2328-9503
DOI:	10.1002/acn3.50999
Popis:	Objective This study evaluates reocclusion prognostic outcomes and explores reocclusion risk factors after mechanical thrombectomy (MT) in Chinese stroke patients. Methods Altogether, 614 patients with AIS with successful recanalization after MT were recruited in this study and divided into the reocclusion and the non‐reocclusion group depending on the 24‐h imaging results after MT. Differences between the two groups were compared including 24‐h and 7‐day National Institutes of Health Stroke Scale (NIHSS) scores, 90‐day modified Rankin scale(mRS) scores, good prognosis (mRS:0–2) rates, incidence of intracranial hemorrhage, and 90‐day mortality. Results Forty‐four (7.2%) patients experienced reocclusion within 24 h. Compared with the non‐reocclusion group, patients in the reocclusion group had higher 24‐h (15 vs. 13) and 7‐day (15 vs. 9) NIHSS scores, 90‐day mRS scores (4 vs. 3), and 90‐day mortality rates (34.1% vs. 18.6%); lower rates of good prognosis (13.6% vs. 9.3%); and a higher incidence of early neurological deterioration (36.4% vs. 14.7%). Age, internal carotid artery occlusion (ICA), intravenous thrombolysis (IVT), number of thrombectomy passes, stent implantation, and levels of D‐dimer (adjusted odds ratio and 95% confidence interval: 0.97, 0.94–0.99; 2.40, 1.10–5.23; 2.21, 1.05–4.66; 2.60, 1.04–6.47; 0.25, 0.09–0.67; and 1.06, 1.01–1.12, respectively) were independently associated with 24‐h reocclusion. Interpretation The prognosis of reocclusion after MT was poor. Timely evaluation of these factors including age, D‐dimer, ICA occlusion, IVT, number of passes, and stent implantation and appropriate intervention could reduce the incidence of reocclusion for Chinese stroke patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b402edad63c8ce75270a10985f662956 https://doi.org/10.1002/acn3.50999 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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