Clinical efficacy and prognostic factors of mechanical thrombectomy in treatment of acute posterior circulation ischemic stroke / 中国介入影像与治疗学

ABSTRACT

Objective: To investigate the clinical efficacy and prognostic factors of mechanical thrombectomy in treatment of acute posterior circulation ischemic stroke. Methods: Totally 15 patients with acute posterior circulation ischemic stroke were treated with mechanical thrombectomy. The successful recanalization rate and adverse reactions (such as intracerebral hemorrhage and infarction) within 24 hours after operation were observed. The prognosis was evaluated with modified Rankin scale (mRS) at 3 months for follow-up. The general data and the related indexes of treatment were compared between patients with good prognosis (mRS scores 0-2) and poor prognosis (mRS scores 3-6). Results: The occluded vessels were recanalized successfully in all 15 patients (15/15, 100%). Within 24 hours after operation, 1 case occured cerebral hemorrhage, 5 cases had massive cerebral infarction. After 3 months, 9 patients had good prognosis and 5 patients had poor prognosis, 1 patient died. Compared with patients with poor prognosis, patients with good prognosis had shorter time from onset to admission (t=-2.435, P=0.030), higher posterior circulation-Alberta stroke prognosis early CT score (pc-ASPECTS) at admission (t=5.925, P<0.001) and lower National Institute of Health stroke scale (NIHSS) score before operation (t=3.053, P=0.009). Conclusion: Intra-arterial mechanical thrombectomy is a safe and effective technique for treatment of acute posterior circulation ischemic stroke. Time from onset to admission, NIHSS score and pc-ASPECTS before operation are prognostic factors.