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• Clinical Article •
To explore the risk factors of outcome after mechanical thrombectomy in acute large area infarction
JIN Mingxu  LI Lu  PENG Mingyang  YIN Xindao  MA Yuehu 

Cite this article as: Jin MX, Li L, Peng MY, et al. To explore the risk factors of outcome after mechanical thrombectomy in acute large area infarction. Chin J Magn Reson Imaging, 2020, 11(9): 730-734. DOI:10.12015/issn.1674-8034.2020.09.003.


[Abstract] Objective: To explore the risk factors of outcome after mechanical thrombectomy (MT) in acute large area infarction.Materials and Methods: In this retrospective study, fifty acute stroke patients who received MT from January 2017 to October 2019 in our hospital were enrolled. Large area infarction was defined as diffusion weighted imaging (DWI)-Alberta stroke program early CT score (ASPECTS)≤5 score. All patients≤24 hours of symptom onset and underwent MR examination before therapy. DWI-ASPECTS score, the functional outcome at 3 months (mRS) and other clinical data were collected. Multivariate logistic regression analysis was used to analyze the independent predictors of stroke.Results: The proportion of patients with blood glucose≤6.8 mmol/L in good functional outcome group (n=18) was significantly higher than that in the poor functional outcome (n=32) (66.67% vs 31.25%; χ2=5.864, P=0.020). There was no significant difference in DWI-ASPECTS score between two groups (4.75±0.25 vs 4.35±0.38; t=2.898, P=0.170), while the proportion of patients with DWI-ASPECTS> 2 score in good functional outcome group was significantly higher than that in the poor functional outcome (88.89% vs 56.25%; χ2=4.240, P=0.026). Multivariable logistic analysis demonstrated that blood glucose ≤6.8 mmol/L (OR, 4.05; 95% CI, 1.05—15.0; P=0.03) and DWI-ASPECTS> 2 score (OR, 6.93; 95% CI, 1.05—45.76; P=0.04) were independently associated with functional outcome.Conclusions: Assessing blood glucose and DWI-ASPECTS could be useful for predicting functional outcome in acute stroke patients with large area infarction and guiding clinical treatment.
[Keywords] cerebral infarction；diffusion weighted imaging；Alberta stroke program early CT score

JIN Mingxu Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 21006, China

LI Lu Department of Radiology, China-Japan Friendship Hospital, Beijing 10029, China

PENG Mingyang Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 21006, China

YIN Xindao Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 21006, China

MA Yuehu* Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 21006, China

*Correspondence to: Ma YH, E-mail: mayuehu1976@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article is supported by the Jiangsu Science and Technology Development Project No. BE2017614
Received  2020-02-25
Accepted  2020-07-20
DOI: 10.12015/issn.1674-8034.2020.09.003
Cite this article as: Jin MX, Li L, Peng MY, et al. To explore the risk factors of outcome after mechanical thrombectomy in acute large area infarction. Chin J Magn Reson Imaging, 2020, 11(9): 730-734. DOI:10.12015/issn.1674-8034.2020.09.003.

[1]
Hankey GJ. Stroke. Lancet, 2017, 389(10069): 641-654.
[2]
耿文，姜亮，陈慧铀，等．急性脑梗死磁共振扩散加权成像与TOAST分型、传统危险因素的关系探讨．磁共振成像, 2018, 9(06): 465-471.
[3]
Campbell BC, Mitchell PJ, Churilov L, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med, 2018, 378(17): 1573-1582.
[4]
van den Berg LA, Dijkgraaf MG, Berkhemer OA, et al. Two-year outcome after endovascular treatment for acute ischemic stroke. N Engl J Med, 2017, 376(14): 1341-1349.
[5]
Albers GW, Marks MP, Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med, 2018, 378(8): 708-718.
[6]
陈慧铀，姜亮，孙军，等. DWI-ASPECTS在评估急性脑梗死患者静脉溶栓预后中的应用．中华神经医学杂志, 2016, 15(1): 6-10.
[7]
Ribo M, Tomasello A, Lemus M, et al. Maximal admission core lesion compatible with favorable outcome in acute stroke patients undergoing endovascular procedures. Stroke, 2015, 46(10): 2849-2852.
[8]
Inoue M, Olivot JM, Labreuche J, et al. Impact of diffusion-weighted imaging alberta stroke program early computed tomography score on the success of endovascular reperfusion therapy. Stroke, 2014, 45(7): 1992-1998.
[9]
Soize S, Barbe C, Kadziolka K, et al. Predictive factors of outcome and hemorrhage after acute ischemic stroke treated by mechanical thrombectomy with a stent-retriever. Neuroradiology, 2013, 55(8): 977-987.
[10]
de Margerie-Mellon C, Turc G, Tisserand M, et al. Can DWI-ASPECTS substitute for lesion volume in acute stroke? Stroke, 2013, 44(12): 3565-3567.
[11]
Gilgen MD, Klimek D, Liesirova KT, et al. Younger stroke patients with large pretreatment diffusion-weighted imaging lesions may benefit from endovascular treatment. Stroke, 2015, 46(9): 2510-2516.
[12]
Han M, Choi JW, Rim NJ, et al. Cerebral infarct volume measurements to improve patient selection for endovascular treatment. Medicine, 2016, 95(35): e4702.
[13]
Coutinho JM, Liebeskind DS, Slater LA, et al. Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke: a pooled analysis of the SWIFT and STAR studies. JAMA Neurol, 2017, 74(3): 268-274.
[14]
ehme D, Kabbasch C, Kowoll A, et al. Intravenous thrombolysis facilitates successful recanalization with stent-retriever mechanical thrombectomy in middle cerebral artery occlusions. J Stroke Cerebrovasc Dis, 2016, 25(4): 954-959.
[15]
Baird TA, Parsons MW, Phan T, et al. Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome. Stroke, 2003, 34(9): 2208-2214.
[16]
Gray CS, Hildreth AJ, Sandercock PA, et al. Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK glucose insulin in stroke trial (GIST-UK). Lancet Neurol, 2007, 6(5): 397-406.
[17]
Alloubani A, Saleh A, Abdelhafiz I. Hypertension and diabetes mellitus as a predictive risk factors for stroke. Diabetes Metab Syndr, 2018, 12(4): 577-584.

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