Abstract
Background and Purpose: Data on the relationship among neutrophil count, intracranial atherosclerotic stenosis (ICAS), and functional outcomes after endovascular thrombectomy (EVT) for ischemic stroke patients remains unclear. We aimed to evaluate the association between neutrophil count and prognosis of EVT patients and to determine whether the association was mediated by ICAS.Methods: We retrospectively analyzed consecutive patients who underwent EVT at two comprehensive stroke centers between June 2016 and December 2019. A remaining stenosis >70%, or a lesser degree of stenosis with a tendency toward re-occlusion or flow impairment during the procedure, was classified as ICAS. A poor outcome was defined as a 90-day modified Rankin Scale score of 3–6.Results: Of the 221 patients (mean age, 65.9 years; males, 61.1%) included in this study, 81 (36.3%) had ICAS, and 120 (54.3%) experienced a poor outcome at 90 days, respectively. In the multivariate adjustment for potential confounders, neutrophil count (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.04–1.36; P = 0.012) and presence of ICAS (OR, 2.65; 95CI%, 1.28–5.45; P = 0.008) were risk factors of poor outcomes. Furthermore, mediation analysis indicated that total ICAS mediated the association between increased neutrophil count and worse functional outcome after EVT (the regression coefficient was changed by 11.7% for poor outcome, and 17.1% for modified Rankin Scale score, respectively).Conclusions: Our study demonstrated that a higher neutrophil count might increase the risk of a poor outcome among ischemic stroke patients who underwent EVT, which was partially mediated by ICAS.
Highlights
Several randomized controlled trials and meta-analyses have confirmed that endovascular thrombectomy (EVT) with stent retriever was a safe and effective way or achieving reperfusion in anterior circulation ischemic stroke caused by occlusion of the proximal anterior artery [1,2,3,4,5]
Patients were recruited in this study if they: [1] had acute intracranial large artery occlusion of the anterior circulation confirmed by computed tomographic angiography, magnetic resonance angiography, or digital subtracted angiography (DSA); [2] were aged 18 years or older; [3] had a pre-stroke modified Rankin Scale score (mRS) score ≤ 2
A total of 221 patients treated with EVT were recruited for the final analysis
Summary
Several randomized controlled trials and meta-analyses have confirmed that endovascular thrombectomy (EVT) with stent retriever was a safe and effective way or achieving reperfusion in anterior circulation ischemic stroke caused by occlusion of the proximal anterior artery [1,2,3,4,5]. EVT with stent retrievers for ICAS may produce blood vessel injury and lead to re-occlusion caused by subsequent platelet aggregation at the site of the intracranial atherosclerotic lesion [8]. The relationship between neutrophil count, presence of ICAS, and functional outcomes after EVT is still unclear. We performed this retrospective multicenter cohort study to assess the association between neutrophil count and prognosis of ischemic stroke patients treated with EVT, and to determine whether the association was mediated by ICAS-related occlusion. Data on the relationship among neutrophil count, intracranial atherosclerotic stenosis (ICAS), and functional outcomes after endovascular thrombectomy (EVT) for ischemic stroke patients remains unclear.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
