Thrombus migration in patients with acute ischaemic stroke undergoing endovascular thrombectomy  

作　　者：ZeFeng Tan Lei Zhang Li'an Huang Hongyu Qiao Min Guan Bing Yang Pengfei Yang Yongwei Zhang Hongjian Shen Yu Zhou Bo Hong Huaizhang Shi Hongxing Han Xinyi Leng Yi Dong Changlin Lian Wenhuo Chen Anding Xu Jianmin Liu 

机构地区：[1]Neurology,First People's Hospital of Foshan,Foshan,Guangdong,China [2]Department of Neurology,Jinan University First Affiliated Hospital,Guangzhou,Guangdong,China [3]Neurovascular Center,Changhai Hospital,Naval Medical University,Shanghai,China [4]Department of Neurosurgery,First Affiliated Hospital of Harbin Medical University,Harbin,China [5]Department of Neurology,Linyi People's Hospital,Linyi,Shandong,China [6]Medicine&Therapeutics,The Chinese University of Hong Kong,Hong Kong,China [7]Neurology,Huashan Hospital Fudan University,Shanghai,China [8]Neurology,Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou,Fujian,China [9]Stroke Center,Jinan University First Affiliated Hospital,Guangzhou,Guangdong,China

出　　处：《Stroke & Vascular Neurology》2024年第2期126-133,I0006-I0395,共398页卒中与血管神经病学（英文）

基　　金：funded by the National Natural Science Foundation of China(No.81825007);Beijing Outstanding Young Scientist Program(No.BJJWZYJH01201910025030);Capital's Funds for Health Improvement and Research(2022-2-2045);National Key R&D Program of China(2022YFF1501500,2022YFF1501501,2022YFF1501502,2022YFF1501503,2022YFF1501504,2022YFF1501505);Youth Beijing Scholar Program(No.010);Beijing Laboratory of Oral Health(PXM2021_014226_000041);Beijing Talent Project-Class A:Innovation and Development(No.2018A12);National Ten-Thousand Talent Plan-Leadership of Scientific and Technological Innovation,and National Key R&D Program of China(No.2017YFC1307900,2017YFC1307905).

摘　　要：Objective The impact of thrombus migration(TM)prior to endovascular thrombectomy(EVT)on clinical outcomes and revascularisation rates remains unknown.We aimed to examine whether preinterventional TM modifies the treatment effects of direct EVT versus bridging EVT in acute large vessel occlusion patients.Methods All patients undergoing catheter angiography in the Direct Intra-arterial thrombectomy in order to Revascularise acute ischaemic stroke patients with large vessel occlusion Efficiently in Chinese Tertiary hospitals:A Multicentre randomised clinical Trial were included.TM was determined by radiologists unaware of the study by analysing discrepancies between computed tomographic angiography at baseline and first-run digital subtraction angiography before EVT.The primary outcome was the score on the modified Rankin scale(mRS)assessed at 90 days.Results Of 627 included patients,the TM rate was 11.3%(71/627).In the multivariable logistic regression model,baseline National Institutes of Health Stroke Scale score(adjusted OR 0.956,95%CI 0.916 to 0.999;p=0.043)and intravenous thrombolysis(adjusted OR 2.614,95%CI 1.514 to 4.514;p<0.001)were independently associated with TM.The patients with TM were less likely to be completely recanalised than those without TM(21.27%vs 36.23%,p=0.040).The interaction of TM and the EVT treatment effect did not significantly affect mRS shift analysis(p=0.687)or mRS scores of 0 to 1(p=0.436).Conclusion Preinterventional TM does not modify the treatment effects of direct versus bridging EVT on functional outcomes in patients with acute ischaemic stroke with anterior large vessel occlusion.TM leads to a lower complete recanalisation rate.

关 键 词：PATIENTS throm ACUTE 

分 类 号：R743.3[医药卫生—神经病学与精神病学]