Angiographic and Clinical Factors Related with Good Functional Outcome after Mechanical Thrombectomy in Acute Cerebral Artery Occlusion

Park, Jong Hyuk; Han, Young Min; Jang, Kyeong Sool; Yoon, Wan Soo; Jang, Dong Kyu; Park, Sang Kyu

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자료유형: 학술저널

저자정보: Park, Jong Hyuk (Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) Han, Young Min (Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) Jang, Kyeong Sool (Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) Yoon, Wan Soo (Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) Jang, Dong Kyu (Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) Park, Sang Kyu (Department of Neurosurgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)

저널정보: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제58권 제3호

발행연도: 2015.1

수록면: 192 - 196 (5page)

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Objective : The aim of this study is to investigate good prognostic factors for an acute occlusion of a major cerebral artery using mechanical thrombectomy. Methods : Between January 2013 to December 2014, 37 consecutive patients with acute occlusion of a major cerebral artery treated by mechanical thrombectomy with stent retrievers were conducted. We analyzed clinical and angiographic factors retrospectively. The collateral flow and the result of recanalization were sorted by grading systems. Outcome was assessed by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at 90 days. We compared the various parameters between good and poor angiographic and clinical results. Results : Twenty seven patients demonstrated good recanalization [Thrombolysis in Cerebral Infarction (TICI) 2b or 3] after thrombectomy. At the 90-day follow up, 19 patients had good (mRS, 0-2), 14 had moderate (3-4) and four had poor outcomes (5-6). The mRS of older patients (${\geq}75years$) were poor than younger patients. Early recanalization, high Thrombolysis in Myocardial Infarction risk score, and low baseline NIHSS were closely related to 90-day mRS, whereas high TICI was related to both mRS and the decrease in the NIHSS. Conclusion : NIHSS decreased markedly only when recanalization was successful. A good mRS was related to low initial NIHSS, good collateral, and early successful recanalization.

#Acute cerebral artery occlusion #Functional outcome #Mechanical recanalization #Prognostic factor #Stent retriever

참고문헌 (25)

참고문헌 신청

Akins PT. / 2014 / Complications of endovascular treatment for acute stroke in the SWIFT trial with solitaire and Merci devices / AJNR Am J Neuroradiol 35:524~528

Alajbegovic A. / 2014 / Post stroke depression / Med Arch 68:47~50

Gyu-Seong Bae / 2012 / Mechanical Thrombectomy Using a Solitaire Stent in Acute Ischemic Stroke; Initial Experience in 40 Patients / Journal of Cerebrovascular and Endovascular Neurosurgery 14(3):164~169

Berkhemer OA. / 2015 / A randomized trial of intraarterial treatment for acute ischemic stroke / N Engl J Med 372:11~20

Broderick JP. / 2013 / Endovascular therapy after intravenous t-PA versus t-PA alone for stroke / N Engl J Med 368:893~903

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