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J Neurol Surg B Skull Base 2023; 84(02): 183-191
DOI: 10.1055/a-1762-0167
Original Article

Risk Factors and Functional Outcomes with Early Neurological Deterioration after Mechanical Thrombectomy for Acute Large Vessel Occlusion Stroke

Hongwei Liu
1   Department of Neurology, Shanxi Medical University, Taiyuan Central Hospital, Shanxi Province, China
,
Yi Zhang
2   Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
,
Haixia Fan
2   Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
,
Chao Wen
1   Department of Neurology, Shanxi Medical University, Taiyuan Central Hospital, Shanxi Province, China
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Abstract

Early neurological deterioration (END) is associated with a poor survival after mechanical thrombectomy (MT) in acute ischemic stroke (AIS). To assess risk factors and functional outcomes of END after MT in patients, we analyzed data from 79 patients who received MT with large-vessel occlusion. END after MT in patients is defined as an increase of two points or more in the National Institute of Health Stroke Scale (NIHSS) score, compared with the best neurological status within 7 days. The mechanism of END can be classified into: AIS progression, sICH, and encephaledema. A total of 32 AIS patients (40.5%) had END after MT. Risk factors for END after MT included: history of oral antiplatelet and/or anticoagulation drugs before MT (OR = 9.56,95% CI = 1.02–89.57), higher NIHSS score when admitted to hospital (OR = 1.24, 95% CI = 1.04–1.48), under the subtype of atherosclerotic stroke (OR = 17.36, 95% CI = 1.51–199.56), ASITN/SIR< 2 (OR = 15.78, 95% CI = 1.65–151.26), and prolonged period from AIS onset to the first revascularization (OR = 1.01, 95% CI = 1.00–1.02). AIS patients who had END at early stages were more likely to experience poor outcomes (Modified Rankin Scale [mRS] >2) at 90 days after MT (OR = 6.829, 95% CI = 1.573–29.655). Thus, AIS patients who had experienced END at early stages were more likely to have poor outcomes (mRS >2) at 90 days after MT, and the risk factors of END were connected to the mechanism of END.

Keywords

mechanical thrombectomy - acute ischemic stroke - early neurological deterioration - risk factors - mechanism


Publication History

Received: 31 July 2021

Accepted: 03 February 2022

Accepted Manuscript online:
04 February 2022

Article published online:
03 March 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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