Clinical analysis of mechanical thrombectomy for acute ischemic stroke: a single-center study of 58 cases

Abstract

Objective To analyze the clinical effect of emergent mechanical thrombectomy on acute ischemic stroke (AIS). Methods We retrospectively studied a total of 58 cases of AIS admitted to Department of Neurosurgery, the Tenth People＇s Hospital Affiliated to Tongji University from January to December of 2016. In all patients, the protocol of establishing stable vascular access was performed and stent retriever combined with manual aspiration was applied. The thrombolysis in cerebral infarction (TICI) score used to assess intraoperative revascularization and head CT scan was performed at 24 h after operation. In patients with stents implanted, CT angiography (CTA) was conducted at 3 days post operation to assess restenosis or occlusion of the stents. The National Institutes of Health Stroke Scale (NIHSS) before discharge and modified Rankin Scale (mRS) score at 90 days post operation were documented. Results Among all 58 cases, successful intraoperative revascularization (TICI score of 2b-3) was achieved in 86.2% (50/58) of the patients. The mean admission-to-puncture time and puncture-to recanalization time were 98.2±21.6 and 45.4±21.3 min. The 24-h postoperative CT scan revealed large-area infarction in 4 patients and intracranial hemorrhage in 7 patients including 2 symptomatic cases. Five cases died before discharge. Long-term follow-up in the remaining 53 cases reported significant statistic difference (P<0.05) between the NIHSS score before discharge (5.9±4.7) and preoperative NIHHS score (13.7±5.3). The 90-d postoperative follow-up results indicated good outcome (mRS score of 0-2) in 68.9% (40/58) of the patients and the mean mRS score was 2.8±2.0. Conclusion With the establishment of stable vascular access and application of stent retriever combined with manual aspiration, emergent mechanical thrombectomy remains an effective treatment method of AIS. Key words: Stroke; Emergencies; Treatment outcome; Mechanical thrombectomy