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Effect and influencing factors of intra-arterial mechanical thrombectomy in the treatment of ischemic stroke |
HU Shan ZHENG Chao HE Huan |
Department of Neurosurgery, General Hospital of Pingxiang Mining Group Co., Ltd., Jiangxi Province, Pingxiang 337000, China |
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Abstract Objective To investigate the effect and influencing factors of intra - arterial mechanical thrombectomy in the treatment of ischemic stroke. Methods Clinical data of 113 patients with ischemic stroke admitted to General Hospital of Pingxiang Mining Group Co., Ltd. from January 2018 to March 2020 were retrospectively analyzed and divided into group A (53 cases) and group B (60 cases) according to treatment methods. Patients in group A were treated with intra-arterial thrombolysis, and patients in group B were treated with intra-arterial mechanical thrombectomy. Group B patients were then divided into good prognosis group (40 cases) and poor prognosis group (20 cases) according to prognosis. The hemodynamic indexes of group A and group B before and 14 days after surgery were compared. The basic clinical data of patients with good prognosis and patients with poor prognosis were compared, and the influencing factors of prognosis were analyzed. Results 14 days after surgery, the maximum peak flow velocity (VS) in group A and B was higher than that before surgery, and group B was higher than group A, while the vascular resistance index (RI) and vascular pulse index (PI) were lower than that before surgery, and group B was lower than group A, the differences were statistically significant (P<0.05). Univariate analysis showed that the proportion of males, the proportion of recanalization, and the preoperative Alberta stroke program early CT (ASPECT) score in the good prognosis group were higher than those in the poor prognosis group, and the time from admission to recanalization was shorter than that in the poor prognosis group. The proportion of posterior circulatory occlusion site, National institutes of health stroke scale (NIHSS)score 24 h after surgery and intracranial hemorrhage rate were lower than those in the poor prognosis group, the differences were statistically significant (P<0.05). Multivariate Losgistic regression analysis showed that the occlusion of the posterior circulation, the time from admission to recanalization≥140 min, the NIHSS score≥10 points at 24 h after surgery, and the occurrence of intracranial hemorrhage at 24 h after surgery were all treated by intraarterial mechanical thrombectomy for ischemic Risk factors for poor prognosis after stroke (P<0.05). Conclusion Intraarterial mechanical thrombectomy can improve the hemodynamics of patients with ischemic stroke and effectively open blood vessels. At the same time, intervention should be aimed at the risk factors of poor prognosis to improve the prognosis of patients.
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