CC-BY-NC-ND 4.0 · J Clin Interv Radiol ISVIR 2017; 01(03): 139-143
DOI: 10.1055/s-0037-1612600
Original Article
Indian Society of Vascular and Interventional Radiology

Predictors of Poor Outcome after Successful Mechanical Thrombectomy in Patients with Acute Anterior Circulation Stroke

Yosuke Tajima
1  Department of Neurosurgery, Kimitsu Chuo Hospital, Kisarazu, Japan
,
Michihiro Hayasaka
1  Department of Neurosurgery, Kimitsu Chuo Hospital, Kisarazu, Japan
,
Koichi Ebihara
1  Department of Neurosurgery, Kimitsu Chuo Hospital, Kisarazu, Japan
,
Masaaki Kubota
1  Department of Neurosurgery, Kimitsu Chuo Hospital, Kisarazu, Japan
,
Sumio Suda
1  Department of Neurosurgery, Kimitsu Chuo Hospital, Kisarazu, Japan
› Author Affiliations
Further Information

Publication History

25 September 2017

30 October 2017

Publication Date:
14 December 2017 (eFirst)

Abstract

Successful revascularization is one of the main predictors of a favorable clinical outcome after mechanical thrombectomy. However, even if mechanical thrombectomy is successful, some patients have a poor clinical outcome. This study aimed to investigate the clinical, imaging, and procedural factors that are predictive of poor clinical outcomes despite successful revascularization after mechanical thrombectomy in patients with acute anterior circulation stroke. The authors evaluated 69 consecutive patients (mean age, 74.6 years, 29 women) who presented with acute ischemic stroke due to internal cerebral artery or middle cerebral artery occlusions and who were successfully treated with mechanical thrombectomy between July 2014 and November 2016. A good outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months after treatment. The associations between the clinical, imaging, and procedural factors and poor outcome were evaluated using logistic regression analyses. Using multivariate analyses, the authors found that the preoperative National Institute of Health Stroke Scale (NIHSS) score (odds ratio [OR], 1.152; 95% confidence interval [CI], 1.004–1.325; p = 0.028), the diffusion-weighted imaging Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) (OR, 0.604; 95% CI, 0.412–0.882; p = 0.003), and a Thrombolysis in Cerebral Infarction (TICI) 2b classification (OR, 4.521; 95% CI, 1.140–17.885; p = 0.026) were independent predictors of poor outcome. Complete revascularization to reduce the infarct volume should be performed, especially in patients with a high DWI-ASPECTS, to increase the likelihood of a good outcome.