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Thrombus migration in patients with acute ischaemic stroke undergoing endovascular thrombectomy.
- Source :
-
Stroke and vascular neurology [Stroke Vasc Neurol] 2024 Apr 30; Vol. 9 (2), pp. 126-133. Date of Electronic Publication: 2024 Apr 30. - Publication Year :
- 2024
-
Abstract
- Objective: The impact of thrombus migration (TM) prior to endovascular thrombectomy (EVT) on clinical outcomes and revascularisation rates remains unknown. We aimed to examine whether preinterventional TM modifies the treatment effects of direct EVT versus bridging EVT in acute large vessel occlusion patients.<br />Methods: All patients undergoing catheter angiography in the Direct Intra-arterial thrombectomy in order to Revascularise acute ischaemic stroke patients with large vessel occlusion Efficiently in Chinese Tertiary hospitals: A Multicentre randomised clinical Trial were included. TM was determined by radiologists unaware of the study by analysing discrepancies between computed tomographic angiography at baseline and first-run digital subtraction angiography before EVT. The primary outcome was the score on the modified Rankin scale (mRS) assessed at 90 days.<br />Results: Of 627 included patients, the TM rate was 11.3% (71/627). In the multivariable logistic regression model, baseline National Institutes of Health Stroke Scale score (adjusted OR 0.956, 95% CI 0.916 to 0.999; p=0.043) and intravenous thrombolysis (adjusted OR 2.614, 95% CI 1.514 to 4.514; p<0.001) were independently associated with TM. The patients with TM were less likely to be completely recanalised than those without TM (21.27% vs 36.23%, p=0.040). The interaction of TM and the EVT treatment effect did not significantly affect mRS shift analysis (p=0.687) or mRS scores of 0 to 1 (p=0.436).<br />Conclusion: Preinterventional TM does not modify the treatment effects of direct versus bridging EVT on functional outcomes in patients with acute ischaemic stroke with anterior large vessel occlusion. TM leads to a lower complete recanalisation rate.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Humans
Male
Female
Aged
Treatment Outcome
Middle Aged
China
Time Factors
Risk Factors
Recovery of Function
Intracranial Thrombosis diagnostic imaging
Intracranial Thrombosis therapy
Intracranial Thrombosis physiopathology
Cerebral Angiography
Computed Tomography Angiography
Functional Status
Risk Assessment
Thrombectomy adverse effects
Endovascular Procedures adverse effects
Endovascular Procedures instrumentation
Ischemic Stroke therapy
Ischemic Stroke diagnostic imaging
Ischemic Stroke physiopathology
Ischemic Stroke diagnosis
Disability Evaluation
Subjects
Details
- Language :
- English
- ISSN :
- 2059-8696
- Volume :
- 9
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Stroke and vascular neurology
- Publication Type :
- Academic Journal
- Accession number :
- 37290931
- Full Text :
- https://doi.org/10.1136/svn-2022-002257