Feasibility and Clinical Outcome Predictors of Mechanical Thrombectomy in Distal Arterial Occlusion Causing Acute Ischemic Stroke: A Monocentric Retrospective Study.

Journal

The neurologist

ISSN: 2331-2637

Titre abrégé: Neurologist

Pays: United States

ID NLM: 9503763

Informations de publication

Date de publication:
07 Nov 2023

Historique:

medline: 29 11 2023

pubmed: 29 11 2023

entrez: 29 11 2023

Statut: aheadofprint

Résumé

The feasibility and clinical outcome predictors of mechanical thrombectomy (MT) for strokes caused by distal arterial occlusion (DAO) remain the subject of debate. A retrospective analysis was conducted of patients with consecutive acute ischemic stroke treated using MT. Clinical and procedural-associated factors were studied to compare the efficacy, safety, and short-term and long-term outcomes of MT between the proximal arterial occlusion (PAO) and DAO groups. The predictors of a good functional outcome in the DAO group were also identified. A total of 116 patients were included in this study, of whom 23 (19.8%) underwent MT for DAO. A higher complete recanalization rate was independently associated with PAO in adjusted models [adjusted odds ratio, 0.596; 95% CI, 0.377-0.941]. The measures of safety and clinical outcome showed no significant differences between the DAO and PAO groups. The National Institute of Health stroke scale (NIHSS) score on admission, hybrid technique use, and complete recanalization rate emerged as independent predictors of a good functional outcome in the DAO group. The efficacy, safety, and short-term and long-term outcomes of DAO thrombectomy were similar to those of PAO thrombectomy. The good functional outcome predictors of MT in DAO included NIHSS on admission, hybrid technique use, and complete recanalization. Overall, the findings lead us to propose that MT may be considered a feasible option for treating DAO after a careful risk-benefit analysis.

Sections du résumé

BACKGROUND BACKGROUND

The feasibility and clinical outcome predictors of mechanical thrombectomy (MT) for strokes caused by distal arterial occlusion (DAO) remain the subject of debate.

METHODS METHODS

A retrospective analysis was conducted of patients with consecutive acute ischemic stroke treated using MT. Clinical and procedural-associated factors were studied to compare the efficacy, safety, and short-term and long-term outcomes of MT between the proximal arterial occlusion (PAO) and DAO groups. The predictors of a good functional outcome in the DAO group were also identified.

RESULTS RESULTS

A total of 116 patients were included in this study, of whom 23 (19.8%) underwent MT for DAO. A higher complete recanalization rate was independently associated with PAO in adjusted models [adjusted odds ratio, 0.596; 95% CI, 0.377-0.941]. The measures of safety and clinical outcome showed no significant differences between the DAO and PAO groups. The National Institute of Health stroke scale (NIHSS) score on admission, hybrid technique use, and complete recanalization rate emerged as independent predictors of a good functional outcome in the DAO group.

CONCLUSIONS CONCLUSIONS

The efficacy, safety, and short-term and long-term outcomes of DAO thrombectomy were similar to those of PAO thrombectomy. The good functional outcome predictors of MT in DAO included NIHSS on admission, hybrid technique use, and complete recanalization. Overall, the findings lead us to propose that MT may be considered a feasible option for treating DAO after a careful risk-benefit analysis.

Identifiants

DOI: 10.1097/NRL.0000000000000543 PMID: 38019091

pubmed: 38019091

doi: 10.1097/NRL.0000000000000543

pii: 00127893-990000000-00116

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Déclaration de conflit d'intérêts

The authors declare no conflict of interest.

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