Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry

Stroke and Vascular Neurology

article

Dapeng Sun¹  Raynald ­¹  Xiaochuan Huo¹  Baixue Jia¹  Xu Tong¹  Anxin Wang⁴  Gaoting Ma¹  Ning Ma¹  Feng Gao¹  Dapeng Mo¹  Zhongrong Miao⁵ 

[1] Department of Interventional Neuroradiology , Beijing Tiantan Hospital, Capital Medical University;Department of Neurology , Beijing Tiantan Hospital, Capital Medical University;Department of Neurosurgery , Beijing Fengtai You anmen Hospital;China National Clinical Research Center for Neurological Diseases , Beijing Tiantan Hospital;1 Department of Interventional Neuroradiology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China 2 Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China 3 Department of Neurosurgery , Beijing Fengtai You anmen Hospital , Beijing , China 4 China National Clinical Research Center for Neurological Diseases , Beijing Tiantan Hospital

关键词: Stroke;    Thrombectomy;   

DOI  :  10.1136/svn-2022-001561

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Objectives To investigate the safety and efficacy of endovascular treatment (EVT) for acute medium vessel occlusion (MeVO) in the anterior circulation and to explore the independent predictors of the 90-day good outcome for such patients.Methods Data from ANGEL-ACT Registry were analysed in our study. The outcomes, such as the modified Rankin Scale (mRS) at 90 days, successful recanalisation rate and symptomatic intracranial haemorrhage (SICH) rate, were compared between MeVO and acute large vessel occlusions (LVO). Then, the independent predictors of the good outcome at 90 days in MeVO patients were determined by the logistic regression analyses.Results We included 1032 subjects in the analysis, of which, 147 were MeVO and 885 were LVO. mRS at 90 days distribution (3 (0–4) vs 3 (0–5), common odds ratio (OR) =1.00, 95% confidence interval (CI) 0.73 to 1.38, p=0.994), SICH rate (4.8% vs 8.9%; OR=0.59, 95% CI 0.26 to 1.34, p=0.205) and successful recanalisation rate (89.8% vs 89.7%; OR=1.00 95% CI 0.51 to 1.93, p=0.992) were similar between the MeVO and LVO groups after adjusting for the confounders. We identified that baseline neutrophil-to-lymphocyte ratio ≤4.1 (OR=2.13, 95% CI 1.14 to 3.99, p=0.019), baseline National Institutes of Health Stroke Scale ≤14 (OR=1.96, 95% CI 1.02 to 3.80, p=0.045) and mechanical thrombectomy passes ≤1 (OR=2.16, 95% CI 1.14 to 4.11, p=0.021) were independent predictors of the 90-day good outcome in MeVO patients undergoing EVT.Conclusions Patients with MeVO achieved similar 90-day mRS, SICH rate and successful recanalisation rate after EVT compared with patients with LVO. Several independent predictors of 90-day good outcome in MeVO patients undergoing EVT were determined, which should be highly considered in MeVO stroke management.

【 授权许可】

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