Risk factors for poor outcomes of mechanical thrombectomy after anterior circulation large vessel occlusion-related acute ischemic strokes

Abstract

Abstract METHODS Patients (N = 313) undergoing MT within a specified time window after onset of ACLVO-related AIS provided clinical and radiologic data for analysis. Clinical endpoints were symptomatic intracranial hemorrhage (sICH) and 90-day functional outcome (scored by modified Rankin Scale [mRS]). Logistic regression was invoked to identify links between clinical/radiologic parameters and clinical outcomes. RESULTS Mean age of patients was 64.0 ± 12.2 years, and women accounted for 29.4%. The median National Institute of Health Stroke Scale [NIHSS] score was 15.2 (interquartile range [IQR]: 12–18). In multivariable analysis, initial Alberta Stroke Program Early CT Score (ASPECTS) determination (odds ratio [OR] = 0.748, 95% confidence interval [CI]: 0.604–0.926; p = 0.008), hyperdense middle cerebral artery sign (HMCAS) (OR = 0.463, 95% CI: 0.238–0.899; p = 0.023), early imaging signs of infarct (OR = 2.837, 95% CI: 1.285–6.263; p = 0.01), baseline NIHSS score (OR = 1.195,95% CI: 1.091–1.309; p < 0.001), age (OR = 1.082,95% CI:1.047–1.118; p < 0.001), and glycosylated hemoglobin (HbA1c) concentration (OR = 1.293, 95% CI: 1.084–1.543; p = 0.004) proved independently predictive of poor clinical outcomes (mRS scores > 2). CONCLUSIONS A number of factors, including initially determined ASPECTS, HMCAS, early imaging signs of infarct, baseline NIHSS score, age, and HbA1c concentration, appear to predict poor outcomes of MT after ACLVO-related AIS.