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Endovascular treatment for acute ischaemic stroke caused by isolated internal carotid artery occlusion: treatment strategies, outcomes, and prognostic factors.
Ni, H; Zhou, C; Hang, Y; Jia, Z-Y; Cao, Y-Z; Shi, H-B; Liu, S; Zhao, L-B.
Afiliación
  • Ni H; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Zhou C; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Hang Y; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Jia ZY; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Cao YZ; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Shi HB; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Liu S; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • Zhao LB; Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. Electronic address: linborzhao@163.com.
Clin Radiol ; 78(6): 451-458, 2023 06.
Article en En | MEDLINE | ID: mdl-36932006
AIM: To describe the experience of endovascular treatment (EVT) of acute ischaemic stroke caused by isolated internal carotid artery (ICA) occlusion, with emphasis on treatment strategies, outcomes, and prognostic factors. MATERIALS AND METHODS: A retrospective examination was performed of 66 consecutive patients with acute moderate-to-severe stroke who underwent EVT for isolated ICA occlusion from July 2016 to June 2021. The modified thrombolysis in cerebral ischaemia (mTICI) score was used to evaluate reperfusion outcomes. A multivariate analysis was performed to identify risk factors associated with poor 90-day outcome (modified Rankin Scale [mRS] 3-6). RESULTS: The National Institutes of Health Stroke Scale (NIHSS) median score of the 66 patients at admission was 15. Twelve patients (18.2%) showed thrombus migration to the M1 segment or proximal M2 during EVT and underwent additional intracranial thrombectomy. Successful reperfusion (mTICI 2b-3) was achieved in 60 patients (90.9%) and complete reperfusion (mTICI 3) in 42 (63.6%). A poor functional outcome was seen in 27 patients (40.9%). The rate of 90-day mortality was 9.1% (6/66). Higher NIHSS scores and a lower Alberta Stroke Program Early CT Score (ASPECTS) were independently associated with poor outcomes. Complete reperfusion was the only treatment factor with a significant predictive value (adjusted odds ratio [OR] 0.03; 95% CI = 0.01 to 0.25; p=0.001). CONCLUSION: Endovascular therapy is safe and effective in patients with acute ischaemic stroke due to isolated ICA occlusion. Prevention of thrombus migration and complete reperfusion should be the aim of EVT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteriopatías Oclusivas / Trombosis / Enfermedades de las Arterias Carótidas / Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares / Accidente Cerebrovascular Isquémico Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Radiol Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteriopatías Oclusivas / Trombosis / Enfermedades de las Arterias Carótidas / Isquemia Encefálica / Accidente Cerebrovascular / Procedimientos Endovasculares / Accidente Cerebrovascular Isquémico Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Radiol Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido