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Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis

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资源类型：

收录情况： ◇ SCIE

作者：
Jia, BaiXue[1] * ; Feng, Lei[2] ; Liebeskind, David S.[3] ; Huo, Xiaochuan[1] ; Gao, Feng[1] ; Ma, Ning[1] ; Mo, Dapeng[1] ; Liao, Xiaoling[4] ; Wang, Chunjuan[5] ; Zhao, Xingquan[4] ; Pan, Yuesong[6] ; Li, Hao[7] ; Liu, Liping[8] ; Wang, Yilong[9] ; Wang, Yongjun[9] ; Miao, Zhong-Rong[1,*1] ;
机构： [1]Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China [2]Department of Radiology, Kaiser Permanente Medical Center, Los Angeles, USA [3]Department of Neurology, Neurovascular Imaging Research Core, UCLA, Los Angeles, California, USA [4]Department of Vascular Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [5]Department of Neurology, Tiantan Clinical Trial and Research Center for Stroke, Beijing Tiantan Hospital, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China [6]Department of Neurology, Tiantan Clinical Trial and Research Center for Stroke, Beijing Tiantan Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China [7]Department of Neurology, China National Clinical Research Center for Neurological Diseases, Tiantan Clinical Trialand Research Center for Stroke, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [8]Neuro-intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China [9]Department of Vascular Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Tiantan Clinical Trial and Research Center for Stroke, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
出处：
DOI： 10.1136/neurintsurg-2017-013489
ISSN：

关键词： atherosclerosis stenosis stent stroke thrombectomy

摘要：
Objective To investigate the safety and efficacy of mechanical thrombectomy plus rescue therapy for intracranial large artery occlusion (ILAO) with underlying intracranial atherosclerosis (ICAS). Methods Patients enrolled in the intervention group of EAST (Endovascular Therapy for Acute ischemic Stroke Trial) were analyzed. For underlying ICAS identified during the stent retrieval procedure, rescue treatment was required for those with (1) a degree of arterial stenosis >70% or (2) any degree of arterial with blood flow impairment or (3) evidence of re-occlusion. Outcomes were compared between the ICAS group and the embolic group. Multivariate logistic regression was performed to determine independent predictors of functional independence at 90 days. Results Among the 140 patients included in the analysis, underlying ICAS was identified in 47 (34%), and 30 patients (21.4%) were considered to be eligible to receive rescue treatment. Of the 30 patients, 27 (90%) actually received rescue therapy. Recanalization rate (95.7% vs 96.8%, P=0.757) and functional independence at 90 days (63.8% vs 51.6%, P=0.169) were comparable between the ICAS group and the embolic group. No significant difference in symptomatic hemorrhage (4.3% vs 4.3%, P=1.000) or death (12.8% vs 12.9%, P=0.982) was found between the two groups. National Institutes of Health Stroke Scale score at presentation (OR=0.865, 95% CI 0.795 to 0.941; P=0.001) and modified Thrombolysis in Cerebral Infarction after the procedure (OR= 2.864, 95% CI 1.018 to 8.061; P=0.046) were independently associated with functional independence at 90 days. Conclusions Mechanical thrombectomy is safe in patients with ILAO with underlying ICAS. By employing a standard rescue therapy, favorable outcomes could be achieved in such patients.

基金：
National Science and Technology Major Project of China [2011BAI08B02, 2015BAI12B04, 2015BAI12B02]
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2017]版：
大类 | 3 区 医学
小类 | 2 区 外科 3 区 神经成像
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 神经成像 1 区 外科
JCR分区：
出版当年[2016]版：
Q1 SURGERY Q2 NEUROIMAGING
最新[2023]版：
Q1 NEUROIMAGING Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

第一作者：
第一作者机构： [1]Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
通讯作者：
通讯机构： [1]Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China [*1]Beijing Tiantan Hospital, Capital Medical University, No.6, Tiantan Xili, Dongcheng district, Beijing 100050, China
推荐引用方式(GB/T 7714)：
Jia BaiXue,Feng Lei,Liebeskind David S.,et al.Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis[J].JOURNAL OF NEUROINTERVENTIONAL SURGERY.2018,10(8):746-+.doi:10.1136/neurintsurg-2017-013489.
APA：
Jia, BaiXue,Feng, Lei,Liebeskind, David S.,Huo, Xiaochuan,Gao, Feng...&Miao, Zhong-Rong.(2018).Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis.JOURNAL OF NEUROINTERVENTIONAL SURGERY,10,(8)
MLA：
Jia, BaiXue,et al."Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis".JOURNAL OF NEUROINTERVENTIONAL SURGERY 10..8(2018):746-+

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