Endovascular thrombectomy can be beneficial to acute ischemic stroke patients with large infarcts
| العنوان: | Endovascular thrombectomy can be beneficial to acute ischemic stroke patients with large infarcts |
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| المؤلفون: | Yi Li, Miao Chen, Chengjin Gao, Ya Peng, Shuming Pan, Hairong Wang, Chao-Hui Jing, Shaowei Jiang, Aihua Fei |
| المصدر: | Journal of Neurosurgery. 130:1383-1390 |
| بيانات النشر: | Journal of Neurosurgery Publishing Group (JNSPG), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, Hospitalized patients, Mortality rate, medicine.medical_treatment, General Medicine, Thrombolysis, medicine.disease, Logistic regression, Surgery, 03 medical and health sciences, Exact test, 0302 clinical medicine, Modified Rankin Scale, medicine, 030212 general & internal medicine, business, Stroke, Acute ischemic stroke, 030217 neurology & neurosurgery |
| الوصف: | OBJECTIVEThis study aimed to assess whether patients with acute ischemic stroke (AIS) and large infarct lesions benefit from reperfusion management. To determine the efficacy of different recanalization managements on AIS patients with Alberta Stroke Program Early CT Score (ASPECTS) < 6, the authors retrospectively analyzed hospitalized patients with AIS.METHODSEighty-nine patients with AIS and ASPECTS < 6 were screened from 13,285 hospitalized patients treated by thrombolysis, thrombectomy, or conventional care in two stroke medical centers. Logistic regression or Fisher’s exact test was performed for comparison of the outcome and risk events between patients treated by thrombectomy (or thrombolysis) and conventional care. The modified Rankin Scale (mRS) score was used to assess the major clinical outcome of patients 3 months after disease onset. Disease outcome was also examined by analyzing symptom improvement at discharge. In particular, mortality and symptomatic intracranial hemorrhage (sICH) were evaluated as risk factors.RESULTSThis study included 21 patients who received thrombolysis, 36 patients receiving thrombectomy, and 32 patients receiving conventional treatment. Among these 3 treatments, only the thrombectomy group clearly showed the most encouraging clinical outcome (mRS score 0–2; p < 0.05, Fisher’s exact test) and marked improvement (OR 25.84, 95% CI 2.44–273.59) compared with conventional treatment. It is noteworthy that the mortality rate of the thrombectomy and thrombolysis group was similar to that of the conventional group, and thrombectomy and thrombolysis increased the risk of sICH in comparison with conventional care (p < 0.05, Fisher’s exact test).CONCLUSIONSPatients with AIS and ASPECTS < 6 definitely benefited from thrombectomy with higher sICH risk, whereas thrombolysis management showed similar efficacy to the control group. |
| تدمد: | 1933-0693 0022-3085 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5b00f2b17510dd067c7d7e40ca8ee69a https://doi.org/10.3171/2017.11.jns171297 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5b00f2b17510dd067c7d7e40ca8ee69a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19330693 00223085 |
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