Endovascular therapy beyond 24 hours for middle cerebral artery atherosclerotic occlusion in acute ischemic stroke
- VernacularTitle:超24小时大脑中动脉粥样硬化闭塞性急性缺血性卒中的血管内治疗
- Author:
Min GUAN
1
;
Hongyu QIAO
1
;
Bing YANG
1
;
Xiufeng XIN
1
;
Shengming HUANG
1
;
Liang ZHANG
1
;
Yingze LIN
1
;
Jie LIANG
1
Author Information
- Publication Type:Journal Article
- Keywords: acute ischemic stroke(AIS); endovascular therapy(EVT); very late time window; middle cerebral artery; atherosclerosis
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(6):925-929
- CountryChina
- Language:Chinese
- Abstract: Objective To assess the clinical and safety outcomes of endovascular therapy(EVT)administered beyond 24 h after the onset of symptoms in patients with acute ischemic stroke(AIS)resulting from middle cerebral artery atherosclerotic occlusion.Methods We enrolled consecutive AIS patients with middle cerebral artery atherosclerotic occlusion who received EVT in our hospital between January 2020 and June 2023 and divided them into two groups based on the time from AIS onset to EVT:EVT≤24 h group and EVT＞24 h group.The National Institutes of Health Stroke Scale(NIHSS)scores after surgery,90-day functional independence(defined as mRS 0-2),symptomatic ICH(sICH),postoperative acute thrombosis,as well as mortality,were analyzed in the two groups of patients.Results A total of 161 patients were recruited,with 106 cases in the EVT≤24 h group and 55 cases in the EVT＞24 h group.The NIHSS scores declined after EVT in both groups(P＜0.01).The NIHSS scores after surgery were lower in the EVT≤24 h group(median:4.5 vs.7.0,P＜0.05).90-day functional independence(45.3％vs.30.9％,95％CI:0.93-3.68),sICH(5.7％vs.9.1％,95％CI:0.18-2.06),postoperative acute thrombosis(6.6％vs.3.6％,95％CI:0.37-9.34),and mortality(3.8％vs.1.8％,95％CI:0.23-19.42)did not differ significantly between the groups(P＞0.05).Conclusion Our findings support EVT feasibility in selected patients with middle cerebral artery atherosclerotic occlusion beyond 24 h.Prospective studies are warranted for confirmation.
