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Predictors of outcome of patients with acute ischemic stroke undergoing thrombectomy

2017-08-05

(MERCI) and Multi MERCI (combined with MERCI) clinical trials to assess the safety and efficacy of thrombectomy in patients with intracranial arterial occlusion within 8 hours of symptom onset. The researchers analyzed 305 patients and 28 baseline variables to identify a good outcome [improved Rankin score ≤ 2 points], death and successful revascularization (myocardial ischemia thrombolytic blood flow grade 2 ~ 3 Level) of the independent predictors.

The results showed that in the univariate analysis, the final revascularization baseline, the NIH Stroke Scale (NIHSS) score, age and systolic blood pressure were associated with 90 days of outcome (including good and death) (P <0.0018 ). In the multivariate analysis, the final revascularization [odds ratio (OR) was 20.4, 95% CI was 7.7 ~ 53.9, P <0.0001], baseline NIHSS score (OR 0.86, 95% CI 0.81 ~ 0.92, P < 0.0001) and age (OR 0.96, 95% CI 0.95 to 0.98, P = 0.0004) were independent predictors of good outcome. (OR = 1.09, 95% CI 1.04 ~ 1.14, P = 0.0001), age (OR 1.05, 95, 95% CI 0.16 ~ 0.50, P <0.0001), baseline NIHSS score % CI was 1.03 ~ 1.07, P <0.0001) and internal carotid artery occlusion (OR 2.17, 95% CI 1.22 ~ 3.86, P = 0.0084) were the strong predictors of death. Systolic blood pressure (<150 mmHg vs ≥ 150 mmHg, OR 0.42, 95% CI 0.26 ~ 0.70, P = 0.0007) and M2 occlusion (OR 3.86, 95% CI 1.28 ~ 11.67, P = 0.0168) Independent predictors of transport reconstruction.

In conclusion, the final recanalization state is a strong predictor of clinical outcome in patients undergoing thrombectomy.The ability to clear blood clots is negatively affected by the level of systolic blood pressure at the time of treatment, possibly due to the high blood pressure. Although carotid artery occlusion is associated with an increased mortality rate, it does not appear to affect the likelihood of a patient getting a good outcome. The study supports the inclusion of intracranial arterial occlusion in future efficacy studies.


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