Relationship between the times of endovascular thrombectomy and the prognosis of acute ischemic stroke / 中国脑血管病杂志

ABSTRACT

Objective To investigate the relationship between the times of thrombectomy and the prognosis of acute ischemic stroke. Methods From June 2014 to June 2016,the clinical data of 61 consecutive patients with ischemic stroke treated with emergency endovascular thrombectomy in Jinling Hospital,Medical School of Nanjing University were collected retrospectively. According to the times of thrombectomy,they were divided into either a routine thrombectomy group ( <3, n =48 ) or a multiple thrombectomy group (≥3,n=13). The modified Rankin scale (mRS) was used to evaluate the neurological function prognosis at 90 d in both groups of patients. The mRS score 0-2 was defined as good prognosis,3-6 were defined as poor prognosis,and 6 was death. Univariate analysis was used to compare the differences between the groups (excluding the patients whose DSA data missing or of poor quality). Spearman correlation analysis was used to evaluate the relationship between the times of thrombectomy and prognosis and fatality rate. Results Univariate analysis showed that the recanalization rate of the patients in the routine thrombectomy group (73. 9%[34/46] vs. 25. 0%[3/12],P =0. 005) and the rate of good collateral compensatory (55. 6%[25/45] vs. 8. 3%[1/12],P =0. 004) were higher than those in the multiple thrombectomy group. The incidence of symptomatic intracranial hemorrhage in the routine thrombectomy group was lower than that in the multiple thrombectomy group (14. 6%[7/48] vs. 53. 8%[7/13],P =0. 003). The mortality rate at 90 days was 18. 0%(n=11). Further Spearman correlation analysis showed that the times of thrombectomy were moderately positive correlated with the mortality rate ( r=0. 517,P=0. 000). There was no significant correlation between the times of thrombectomy and the good function prognosis (r=0. 076,P=0. 560). However,the effects of the differences between recanalization rate,collateral compensation and symptomatic intracranial hemorrhage could not be ruled out. Conclusion Emergency intravascular interventional therapy of multiple thrombectomy is positively related to the mortality rate at 90 d in patients with acute ischemic stroke,however,a study with larger sample is needed to confirm it.