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Tytuł:
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The Therapeutic Effects of Endovascular Therapy with mTICI2b and 3 Recanalization for Acute Anterior Circulation Stroke Patients.
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Autorzy:
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Zhang YH; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Shi MC; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Wang ZX; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Li C; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Zhou J; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Qin C; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Wang C; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China.
Wang SC; Department of Neurology, The First Hospital of Jilin University, Xinmin Street 1#, Changchun 130021, China. Electronic address: .
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Dec; Vol. 29 (12), pp. 105335. Date of Electronic Publication: 2020 Sep 29.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Endovascular Procedures*/adverse effects
Endovascular Procedures*/mortality
Thrombectomy*/adverse effects
Thrombectomy*/mortality
Stroke/*therapy
Aged ; Cerebrovascular Circulation ; China ; Disability Evaluation ; Female ; Humans ; Intracranial Hemorrhages/etiology ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Risk Factors ; Stroke/diagnosis ; Stroke/mortality ; Stroke/physiopathology ; Time Factors ; Treatment Outcome
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Contributed Indexing:
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Keywords: Emergent large vessel occlusion; Outcome; Stroke; Thrombectomy; mTICI
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Entry Date(s):
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Date Created: 20201002 Date Completed: 20201207 Latest Revision: 20201214
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Update Code:
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20240105
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DOI:
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10.1016/j.jstrokecerebrovasdis.2020.105335
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PMID:
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33007680
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Background and Purpose: Modified Thrombolysis in Cerebral Infarction (mTICI)2b/3 has been considered the criterion for successful reperfusion in endovascular treatment. This study aimed to compare the therapeutic safety and efficacy of mTICI2b and mTICI3 recanalization, and to analyze the factors related to outcomes in everyday clinical practice.
Materials and Methods: This is a single-center retrospective analysis of 224 patients who underwent successful thrombectomy (achieving a mTICI score ≥2b). The primary outcomes included a modified Rankin score (mRS) of 0-2 at 90-day, mortality, and symptomatic intracranial hemorrhage.
Results: A total of 111 patients achieved mTICI2b status (49.6%), and 113 achieved mTICI3 status (50.4%). The comparison between mTICI2b and 3 reperfusions showed no differences in short-term outcomes, 90-day mRS, complications, and mortality. There was a trend toward more passes in mTICI2b patients, although the difference was not significant. The univariate analysis showed that poor outcomes after endovascular treatment were associated with older age, previous history of coronary heart disease, atrial fibrillation, diabetes, tandem occlusions, high National Institutes of Health Stroke Scale (NIHSS) score on admission, and general anesthesia. A previous history of coronary heart disease, a high NIHSS score on admission, and the use of general anesthesia were independent factors that affected the therapeutic effects.
Conclusion: The superiority (efficacy and safety) of mTICI3 reperfusion was not significant compared with that of mTICI2b reperfusion. Prolonged efforts to achieve mTICI3 after achieving mTICI2b should be considered prudently for those with difficulty achieving 100% reperfusion.
Competing Interests: Declaration of Competing Interest None declared.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
