Prognosis and risk factors for reocclusion after mechanical thrombectomy.

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  • Additional Information
    • Source:
      Publisher: Wiley Periodicals, Inc on behalf of American Neurological Association Country of Publication: United States NLM ID: 101623278 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2328-9503 (Electronic) Linking ISSN: 23289503 NLM ISO Abbreviation: Ann Clin Transl Neurol Subsets: MEDLINE
    • Publication Information:
      Original Publication: [Hoboken, NJ] : Wiley Periodicals, Inc on behalf of American Neurological Association, [2014]-
    • Subject Terms:
      Mechanical Thrombolysis*/adverse effects ; Mechanical Thrombolysis*/statistics & numerical data ; Outcome Assessment, Health Care*/methods; Arterial Occlusive Diseases/*therapy ; Ischemic Stroke/*therapy; Aged ; Arterial Occlusive Diseases/diagnosis ; Arterial Occlusive Diseases/epidemiology ; China ; Female ; Humans ; Ischemic Stroke/diagnosis ; Ischemic Stroke/epidemiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors
    • Abstract:
      Objective: This study evaluates reocclusion prognostic outcomes and explores reocclusion risk factors after mechanical thrombectomy (MT) in Chinese stroke patients.
      Methods: Altogether, 614 patients with AIS with successful recanalization after MT were recruited in this study and divided into the reocclusion and the non-reocclusion group depending on the 24-h imaging results after MT. Differences between the two groups were compared including 24-h and 7-day National Institutes of Health Stroke Scale (NIHSS) scores, 90-day modified Rankin scale(mRS) scores, good prognosis (mRS:0-2) rates, incidence of intracranial hemorrhage, and 90-day mortality.
      Results: Forty-four (7.2%) patients experienced reocclusion within 24 h. Compared with the non-reocclusion group, patients in the reocclusion group had higher 24-h (15 vs. 13) and 7-day (15 vs. 9) NIHSS scores, 90-day mRS scores (4 vs. 3), and 90-day mortality rates (34.1% vs. 18.6%); lower rates of good prognosis (13.6% vs. 9.3%); and a higher incidence of early neurological deterioration (36.4% vs. 14.7%). Age, internal carotid artery occlusion (ICA), intravenous thrombolysis (IVT), number of thrombectomy passes, stent implantation, and levels of D-dimer (adjusted odds ratio and 95% confidence interval: 0.97, 0.94-0.99; 2.40, 1.10-5.23; 2.21, 1.05-4.66; 2.60, 1.04-6.47; 0.25, 0.09-0.67; and 1.06, 1.01-1.12, respectively) were independently associated with 24-h reocclusion.
      Interpretation: The prognosis of reocclusion after MT was poor. Timely evaluation of these factors including age, D-dimer, ICA occlusion, IVT, number of passes, and stent implantation and appropriate intervention could reduce the incidence of reocclusion for Chinese stroke patients.
      (© 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association.)
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    • Publication Date:
      Date Created: 20200311 Date Completed: 20210419 Latest Revision: 20210419
    • Publication Date:
      20240628
    • Accession Number:
      PMC7187702
    • Accession Number:
      10.1002/acn3.50999
    • Accession Number:
      32154677