机构：[1]Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing, Jiangsu Province, China[2]Department of Neurology, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, Fujian Province, China[3]Department of Neurology, The 123rd Hospital of The People’s Liberation Army, Bengbu, Anhui Province, China[4]Department of Neurology, The 89th Hospital of The People’s Liberation Army, Weifang, Shandong Province, China[5]Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu Province, China[6]Department of Emergency Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China[7]Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China[8]Department of Interventional Radiology, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu Province, China[9]Department of Neurology, The 175th Hospital of The People’s Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, Fujian Province, China[10]Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
Objective: The objective of this article is to compare the effectiveness of primary angioplasty and/or stenting with stent retriever thrombectomy in acute anterior large-vessel occlusion due to atherosclerotic disease. Methods: Patients were retrospectively reviewed from the endovascular treatment for acute anterior circulation ischemic stroke registry. Patients with large-vessel occlusions due to atherosclerosis were selected. We evaluated modified Rankin Scale (mRS) score at 90 days, modified thrombolysis in cerebral infarction (mTICI) score immediately post-procedure, and symptomatic and asymptomatic intracranial hemorrhage within 72 hours. Results: Of 302 patients with acute anterior circulation occlusion due to atherosclerotic disease, 269 were treated with stent retriever thrombectomy as first-line therapy and 33 with angioplasty and/or stenting. Patients who received primary angioplasty treatment showed favorable independent outcome at 90 days (69.7% (23/33) vs 47.6% (128/269), p = 0.02) and lower rate of asymptomatic intracranial hemorrhage (9.1% (3/23) vs 30.5% (82/269), p = 0.01). Recanalization immediately post procedure did not differ (78.8%% (26/33) vs 86.2% (232/269), p = 0.29). Primary angioplasty therapy (OR, 0.27; 95% confidence interval (CI): 0.08-0.90; p = 0.03) and small baseline infarct (OR 0.36: 0.16-0.82; p = 0.02) were protective factors against poor functional outcome, while old age (OR 1.04: 1.01-1.07; p = 0.006), severe neurological deficits (OR 3.76: 2.00-7.07; p<0.001), and high glucose (OR 1.11: 1.01-1.23; p = 0.03) were associated with poor prognosis. Conclusions: Patients with acute anterior circulation large-vessel occlusion due to atherosclerosis may benefit from urgent angioplasty and/or stenting as first-line therapy. Randomized controlled trials are warranted.
基金：
This project was supported by the National Natural
Science Foundation of China (No. 81400898, 81400993,
81571143 and 81671172) and the Chinese Postdoctoral
Science Fund (No. 2015M572815).
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2017]版：
大类|4 区医学
小类|4 区临床神经病学4 区核医学
最新[2023]版：
大类|4 区医学
小类|4 区临床神经病学4 区核医学
JCR分区：
出版当年[2016]版：
Q4CLINICAL NEUROLOGYQ4RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版：
Q3CLINICAL NEUROLOGYQ3RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGINGQ4CLINICAL NEUROLOGY
第一作者机构：[1]Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing, Jiangsu Province, China
共同第一作者：
通讯作者：
通讯机构：[*]Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu, China.
推荐引用方式(GB/T 7714)：
Dong Yang,Min Lin,Shuiping Wang,et al.Primary angioplasty and stenting may be superior to thrombectomy for acute atherosclerotic large-artery occlusion[J].INTERVENTIONAL NEURORADIOLOGY.2018,24(4):412-420.doi:10.1177/1591019918763380.
APA：
Dong Yang,Min Lin,Shuiping Wang,Huaiming Wang,Yonggang Hao...&Xinfeng Liu.(2018).Primary angioplasty and stenting may be superior to thrombectomy for acute atherosclerotic large-artery occlusion.INTERVENTIONAL NEURORADIOLOGY,24,(4)
MLA：
Dong Yang,et al."Primary angioplasty and stenting may be superior to thrombectomy for acute atherosclerotic large-artery occlusion".INTERVENTIONAL NEURORADIOLOGY 24..4(2018):412-420
