A comparative study on efficacy and safety of bridging thrombectomy and direct thrombectomy in patients with acute anterior circulation large core infarction
10.3760/cma.j.cn115354-20241116-00717
- VernacularTitle:急性前循环大核心梗死患者桥接取栓与直接取栓的有效性及安全性对照研究
- Author:
Hao QIN
1
;
Hailong ZHONG
;
Haocun ZHENG
;
Yifeng LIU
;
Meijuan KANG
;
Changming WEN
Author Information
1. 新乡医学院南阳市中心医院神经介入科，南阳 453003
- Publication Type:Journal Article
- Keywords:
Acute ischemic stroke;
Large core infarction;
Endovascular treatment;
Intravenous thrombolysis;
Bridging thrombectomy
- From:
Chinese Journal of Neuromedicine
2025;24(5):481-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of bridging thrombectomy and direct thrombectomy in patients with acute anterior circulation large core infarction.Methods:A retrospective cross-sectional study was performed; 131 patients with acute anterior circulation large core infarction with an onset time≤ 24 hours received endovascular treatment (EVT) at Department of Intervention Neurosurgery, Nanyang Central Hospital, Xinxiang Medical University, from June 2022 to June 2024 were chosen; they were divided into bridging thrombectomy group (accepted intravenous thrombolysis [IVT] before EVT, n=55) and direct thrombectomy group ( n=76). Statistical analysis was conducted to compare the differences in efficacy and safety between the two groups. Efficacy indicators included modified Rankin scale (mRS) score 90 days after thrombectomy, and good prognosis rate 90 days after thrombectomy (mRS scores of 0-2). Safety indicators included intracranial hemorrhage (ICH) incidence within 72 hours of thrombectomy, symptomatic intracranial hemorrhage (sICH) incidence within 72 hours of thrombectomy, mortality 90 days after thrombectomy, and ratio of patients receiving decompressive craniectomy after surgery. Results:No significant difference between the direct thrombectomy group and bridging thrombectomy group was noted in terms of mRS score 90 days after thrombectomy (3 [2, 6] vs. 3 [2, 6]), good prognosis rate 90 days after thrombectomy (38.2% vs. 25.5%), ICH incidence within 72 hours of thrombectomy (30.3% vs. 40.0%), sICH incidence within 72 hours of thrombectomy (21.1% vs. 21.8%), mortality rate within 90 days of thrombectomy (28.9% vs. 25.5%), and ratio of patients receiving decompressive craniectomy after surgery (9.2% vs. 9.1%, P>0.05). Core infarction volume at 100 mL was used as grouping standard, subgroup analysis showed that when the core infarction volume was 70-100 mL and >100 mL, respectively, no significant difference in sICH incidence was noted between the bridging thrombectomy group and direct thrombectomy group ( P>0.05). Conclusion:For patients with acute anterior circulation large core infarction with an onset time≤ 24 hours, bridging thrombectomy has similar efficacy and safety as direct thrombectomy.
