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  • Title: Risk factors for ineffective recanalization after endovascular treatment in acute ischemic stroke.
    Author: Fan L, Han W, Zhang Y, Zhou M, Ye H, Chen W, Su Y.
    Journal: Clin Neurol Neurosurg; 2021 Jan; 200():106362. PubMed ID: 33243698.
    Abstract:
    OBJECTIVE: To assess the risk factors of early ineffective recanalization, defined as a modified Rankin scale (mRS) score of 4∼6 at two weeks after symptom onset, in acute ischemic stroke (AIS) patients receiving endovascular treatment (EVT). METHOD: One hundred eighty-four AIS patients who received EVT in 01/2016-12/2018 were analyzed. The recanalization rate was 81.5 % (150/184). Patients were divided into effective (mRS 0-3) and ineffective (mRS 4-6) recanalization groups. The independent risk factors for ineffective recanalization were analyzed. RESULT: The ineffective recanalization rate was 67.3 % (101/150 cases) at 14 days after symptom onset. Twenty-five patients (24.8 %) in the ineffective recanalization group had coronary heart disease, higher than that in the effective group (4 patients, 8.2 %, P = 0.016). Infratentorial pathology accounted for 34.7 % (35 cases) of the ineffective group and only 14.3 % (7 cases) of the control group (P = 0.011). Systolic blood pressure (SBP) was higher in the ineffective group than in the effective group (146 mmHg vs 140 mmHg, P = 0.038). General anesthesia was more common in the ineffective group than in the control group (49 cases, 48.5 %, vs 9 cases, 18.4 %; P = 0.000). Logistic regression showed that coronary heart disease (odds ratio (OR) = 3.399, 95 % confidence interval (CI) 1.013-11.401, P = 0.048), unconsciousness before EVT (OR = 4.292, 95 % CI 1.963-9.386, P = 0.000), SBP (OR = 1.016, 95 % CI 0.997-1.035, P = 0.090) and general anesthesia (OR = 3.378, 95 % CI 1.395-8.180, P = 0.007) were independent risk factors for ineffective recanalization. CONCLUSION: Patients with coronary heart disease, unconsciousness before EVT, elevated SBP and general anesthesia need precise assessment to benefit from EVT.
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