Clinical efficacy of enclovascular thrombectomy in patients with ischemic stroke beyond the time window
10.3969/j.issn.1672-5921.2019.10.006
- Author:
Huixun QIN
1
Author Information
1. Department of Neurology, Liuzhou People's Hospital
- Publication Type:Journal Article
- Keywords:
Arterial occlusivc diseases;
Beyond the time window;
Endovascular thrombectomy;
Stroke
- From:
Chinese Journal of Cerebrovascular Diseases
2019;16(10):533-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of endovascular thrombectomy in patients with acute anterior circulation stroke with large vessel occlusion beyond the time window. Methods From January 2014 to September 2018,182 patients with acute anterior circulation stroke with large vessel occlusion and treated with endovascular thrombectomy in the Department of Neurology of Liuzhou People's Hospital were retrospectively included. Preoperative CT angiography or MR angiography confirmed the presence of internal carotid artery or middle cerebral artery occlusion. According to the symptom onset to puncture (OTP) time, patients were divided into the within time windov group(0TP^6 h, 156 cases) and the beyond lime window group (OTP >6 h,26 eases). Data collected and analyzed between the two groups included age, gender, cerebrovascular disease risk factors, emergency blood glucose, the United Stales .National Institutes of Health Stroke Scale( MUSS) score,stroke etiology classification, Albena Stroke Program Early CT( ASPECT) score,the American Society of Interventional and Therapeutic Ncuroradiology/Society of Interventional Radiology (ASITN/S1H) scale, occlusion site, intravenous thrombolysis ratio, imaging data.operation lime node,number of thrombectomy,remedy treatment and recanalizalion. Also, complications and clinical prognosis of the two groups v»cre evaluated. 'Hie successful recanalizalion was defined as modified thrombolysis in cerebral infarction (mTICl) 2li or 3. According to the 90 d modified Rankin scale (mKS) score,0-2 was considered as favorable outcome,and 6 was considered as death. Results (I )No significant difference∗ were between the two groups in age,gender .hypertension,atrial fibrilUliu:i,hyj>erlipidcmia,diabetes, history of cerebral infarction,smoking history,baseline N1HSS score. ASPECT score, Wood glucose level, occlusions site and AS1TN/SIR scale0-1 (all I' >0.05). The intravenous thrombolysis proportion in the within time window group was higher than that in the beyond time window group,and the difference was statistically significant (38.5<∗ (60/156 J «. 11.5%[3/26] rf = 7. 137,/'= 0.OOS). (2) Tbere were no statistically significant differences in etiology classification, time from OTP to recanalizatkm, number of thrombectomy,mTICl 2b-3 and remedial treatment between the two groups (all >0. 05). In the within timr window group,llie time from symptom onset to imaging examination ( 146[ 110.229] min a. 307(234, 349] min./f a-5.182) .the timr fromsymptom OTP (240[ 190,298] min w.395(379.533] nin,Z=-8.015), and the time from symptom onset to recanalizalion (329(281,3X8] min 1x492(442.567] min,/=-6.618) were idl significantly shorter than those in the beyond lime window group (all P <0. 01). (3) There was no statistically significant difference in the incidence of symptomatic intracranial hemorrhage and asymptomatic intracranial hemoahagc 24 hours after operation between the two groups (Ixiih P > 0.05 ). After 3 months of follow-up,there was no statistically significant difference in the proportion of favorable outcome and mortality ljetwren the two groups (both/' > 0.05). Conclusion Intravascular thrombectomy for acute anterior circulation stroke with large vessel occlusion beyond the lime window has comparably good prognosis with that of patients within the lime window, without increasing tl>e 90 <1 incidence of symptomatic intracranial hemoahagc and mortality.
