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• Technical Article •
To explore the outcome differences in acute ischemic stroke with different time windows after mechanical thrombectomy
WANG Wei  ZHAO Jing  PENG Mingyang  XIE Guanghui  YIN Xindao  ZHANG Yan 

Cite this article as: Wang W, Zhao J, Peng MY, et al. To explore the outcome differences in acute ischemic stroke with different time windows after mechanical thrombectomy[J]. Chin J Magn Reson Imaging, 2021, 12(3): 39-43. DOI:10.12015/issn.1674-8034.2021.03.009.


[Abstract] Objective We aimed at studying the outcome in acute ischemic stroke with different time windows after mechanical thrombectomy if they present with a diffusion-weighted imaging (DWI)-perfusion-weighted imaging (PWI) mismatch. Materials andMethods In this retrospective study, 200 acute stroke patients who received mechanical thrombectomy in our hospital were enrolled. All patients ≤24 hours of symptom onset and underwent MR examination before and after therapy. The vascular recanalization was assessed by mTICI grade. DWI volume, PWI abnormal volume, the functional outcome at 3 months (mRS) and other clinical data were collected. According to the median time window, the patients were divided into early time window and late time window group. Statistical analysis was used to analyze the outcome differences in acute stroke with different time windows.Results According to the median time window, patients were divided into early time window group (≤300 min; n=118) and late time window group (＞300 min; n=82); There was no significant difference in DWI infarct volume on admission and DWI-PWI mismatch volume between two groups (P＞0.05). However, compared with late time window group, DWI infarct growth volume [11 mL (1—45 mL) vs. 29 mL (3—87 mL)] in early time window group was smaller and the proportion of good functional outcome was higher (62.71% vs. 39.02%), the differences showed statistically significant (t=-2.371, P=0.027; χ2=10.898, P=0.001). Multivariable logistic analysis demonstrated that vascular recanalization (OR, 3.75; 95% CI: 1.43—10.86; P=0.008), DWI infarct growth volume (OR, 0.73; 95% CI: 0.58—0.95; P=0.017) and time window (OR, 0.41; 95% CI: 0.11—0.79; P=0.005) were independently associated with functional outcome.Conclusions Outcome of acute stroke patients with DWI-PWI mismatch is time-dependent. Early time window, complete vascular recanalization and small DWI infarct growth volume are beneficial to the good functional outcome in acute stroke patients after mechanical thrombectomy.
[Keywords] stroke；diffusion weighted imaging；perfusion-weighted imaging；outcome；time window

WANG Wei1   ZHAO Jing2   PENG Mingyang1   XIE Guanghui1   YIN Xindao1   ZHANG Yan2*  

1 Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 21006, China

2 Department of Radiology, Eastern Theater General Hospital, QinHuai District Medical Area, Nanjing 21002, China

Zhang Y, E-mail: 59717937@qq.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article is supported by the Jiangsu Science and Technology Development Project No. BE2017614 This article is supported by the Natural science of Jiangsu Province No. BK20201118
Received  2020-11-26
Accepted  2021-01-21
DOI: 10.12015/issn.1674-8034.2021.03.009
Cite this article as: Wang W, Zhao J, Peng MY, et al. To explore the outcome differences in acute ischemic stroke with different time windows after mechanical thrombectomy[J]. Chin J Magn Reson Imaging, 2021, 12(3): 39-43. DOI:10.12015/issn.1674-8034.2021.03.009.

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