Risk Factors, Susceptibility Vessel Sign and Thrombosis Pathology for Prognosis in Patients With Different Subtypes of Acute Ischemic Stroke Treated With Mechanical Thrombectomy

Abstract

Purpose This study highlights the relationship between stroke subtypes, thrombosis pathology, and susceptibility vessel sign (SVS) and identifies probable risk factors affecting recanalization and outcomes in endovascular treatment. Methods A prospective study was conducted in which 53 acute ischemic stroke patients received intravenous thrombolysis and mechanical thrombectomy (MT) from January 2017 to December 2019 in a native hospital. The recanalization was evaluated using modified cerebral infarction thrombolysis grade and prognosis at 3 months using modified Rankin Scale (mRS). The risk factors were identified using univariate and multivariate logistic regression analyses. The thrombus samples were stained to determine their composition. Magnetic sensitivity-weighted imaging was used to determine SVS. Results Age, locations of occlusion, and treatments were significantly different of TOAST (Trial of Org 10172 in Acute Stroke Treatment) subtypes (P < 0.05). The time from door to puncture (TDP) and time of operation (TO) were significantly lower in the successful recanalization group (P < 0.05). National Institutes of Health Stroke Scale (NIHSS), MT, TDP, time from onset to recanalization (TOR), and TO have significant differences between the two groups of mRS ≤ 2 and > 3. The occurrence of symptomatic intracranial hemorrhage (sICH) significantly affected the mRS score. The red and mixed thrombi were common in patients with positive SVS whereas the white thrombi were associated with the negative SVS. Conclusion Improved recanalization and prognosis was observed in early MT and when endovascular operations time was reduced.