Risk factors for lower extremity deep vein thrombosis in acute stroke patients following endovascular thrombectomy: a retrospective cohort study

Frontiers in Neurology

Neurology

Xiao-Ping Xu¹  Feng Wang¹  Li Han¹  Yang Liu²  Wei-Yang Qian³  Jian-Miao Yang⁴  Tao-Hsin Tung⁵ 

[1] Department of Neurology, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China;Department of Neurology, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China;Department of Neurology, Saarland University, Homburg, Germany;Department of Neurosurgery, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China;Department of Pharmacy, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China;Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China;

关键词: acute ischemic stroke;    endovascular thrombectomy;    deep vein thrombosis;    risk factors;    D-dimer (DD);   

DOI  :  10.3389/fneur.2023.1249365

 received in 2023-06-28, accepted in 2023-09-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundDeep vein thrombosis (DVT) in lower extremities as a common complication of acute ischemic stroke (AIS) has long been studied. However, as the therapeutic options for AIS continue to advance, the pathogenic mechanisms behind DVT may change. Endovascular thrombectomy (EVT) has replaced intravenous thrombolysis and become the preferred treatment for AIS patients with large vessel occlusions. Therefore, it is important to update our understanding of DVT and its management. This study aimed to determine the prevalence and risk factors of DVT in AIS patients following EVT.MethodsIn this retrospective study, 245 AIS patients who had received EVT were recruited between January 2020 and December 2021. Within 10 days (median 4 days) of thrombectomy, DVT was diagnosed by ultrasonography. Demographic characteristics, clinical findings, and therapeutic procedures were compared between patients with and without DVT using univariate analysis. Cutoff points were defined for EVT time and plasma D-dimer concentration. Multivariable logistic regression was then used to determine the independent risk factors for DVT and evaluate their predictive power.ResultsThe prevalence of DVT in AIS patients after EVT was 27.3%. Multifactorial logistic regression analysis showed that age (OR 1.036, 95% CI 1.001–1.073; P = 0.045), female sex (OR 3.015, 95% CI 1.446–6.289; P = 0.003), lower limb muscle strength less than grade three (OR 7.015, 95% CI 1.887–26.080; P = 0.004), longer EVT time (OR 1.012, 95% CI 1.004–1.020; P = 0.003), and higher D-dimer levels (OR 1.350, 95% CI 1.150–1.585; P < 0.001) were independently associated with higher DVT risk in AIS patients following EVT. The cutoff points for operative time of EVT and plasma D-dimer were 65.5 min and 1.62 mg/L, respectively, above which the risk for DVT was dramatically increased with OR > 4 in AIS patients.ConclusionAIS patients are at increased risk of developing DVT following EVT particularly if they have undergone prolonged thrombectomy procedures and exhibit high plasma levels of D-dimers. However, the results of our study need to be validated by a multicenter prospective study with a larger population of stroke patients.

【 授权许可】

Unknown   
Copyright © 2023 Han, Yang, Qian, Xu, Tung, Liu and Wang.