Efficacy of endovascular treatment for acute ischemic stroke with large core infarction and its influencing factors

Abstract

Objective To investigate the efficacy and influencing factors of early endovascular treatment (EVT) in the patients encountering acute ischemic stroke with large vessel occlusion (AIS-LVO) in the anterior circulation accompanying large core infarction. Methods The clinical data of 31 patients diagnosed as AIS-LVO accompanying large core infarction who underwent EVT in our hospital from January to November 2020 were collected and retrospectively analyzed. Basic information such as age and gender, as well as National Institutes of Health Stroke Scale (NIHSS) score, Alberta Stroke Project Early Computed Tomography (ASPECTS) score, and collateral circulation scores were collected. Postoperative revascularization condition and antiplatelet medication therapy were also recorded. The patients were subsequently divided into good and poor prognosis groups according to the modified Rankin scale (mRS) in 90 d after surgery. The related predictors for good prognosis here explored by multivariate logistic regression analysis. Results Twenty-five cases (80.6%) obtained postoperative revascularization; the incidence of intracranial hemorrhage (ICH) was 41.9%, with 12.9% being symptomatic intracranial hemorrhage (sICH); the good prognosis rate was 32.2% at 90th day after surgery, and the mortality rate was 12.9%. The patients in the good prognosis group had younger age than those in the poor prognosis group (mRS>2) (OR=0.804, 95% CI=0.657~0.983, P=0.034). Conclusion The patients of AIS-LVO accompanying large core infarction can partially benefit from endovascular treatment, and the age of patients is an important factor affecting prognosis.

Keywords

• large core infarction
• large vessel occlusion
• acute ischemic stroke
• endovascular treatment