The relationship between periprocedural thrombus migration and clinical outcomes in patients with acute large vessel occlusion after mechanical thrombectomy
10.3760/cma.j.cn113694-20210613-00410
- VernacularTitle:急性大血管闭塞性卒中机械取栓术中血栓逃逸与预后的关系
- Author:
Chu CHEN
1
;
Tangqin ZHANG
;
Youqing XU
;
Lili YUAN
;
Xiangjun XU
;
Ke YANG
;
Qian YANG
;
Xianjun HUANG
;
Zhiming ZHOU
Author Information
1. 皖南医学院弋矶山医院神经内科，芜湖241001
- Keywords:
Thromboembolism;
Stroke;
Risk factors;
Prognosis;
Mechanical thrombectomy
- From:
Chinese Journal of Neurology
2021;54(10):1025-1032
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the early predictive factors of periprocedural thrombus migration and the relationship between periprocedural thrombus migration and prognosis after mechanical thrombectomy (MT) in stroke patients.Methods:The patients with anterior circulation acute large vessel occlusion stroke (ALVOS) who underwent MT in the Stroke Center of Yijishan Hospital of Wannan Medical College from May 2015 to December 2019 were retrospectively analyzed. The baseline characteristics, procedural and clinical outcomes were collected. Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results:There were 302 ALVOS patients [(68.8±11.0) years old and 166 males (55.0%)] included, of whom thrombus migration was identified in 80 patients (26.5%), including 60 cases (75.0%) of proximal migration. Cardiogenic stroke ( OR=2.722, 95% CI 1.367-5.418, P=0.004) and clot burden score (CBS; OR=0.849, 95% CI 0.745-0.968, P=0.015) were independent risk factors of thrombus migration. Proximal migration ( OR=2.822, 95% CI 1.220-6.528, P=0.015) was an independent risk factor of 90-day clinical outcome, while the effect of distal migration on 90-day clinical outcome was not statistically significant. Conclusions:Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in ALVOS patients who underwent MT. Proximal migration is an independent risk factor for the prognosis of patients, which has important clinical intervention significance.
