Efficacy of endovascular intervention in the very late time window on anterior circulation large-vessel occlusion-acute ischemic stroke
Objective To investigate the efficacy and safety of endovascular intervention in the very late time window for anterior circulation large-vessel occlusion-acute ischemic stroke(LVO-AIS).Methods Eighty-eight patients with anterior circulation LVO-AIS were diagnosed and treated in the very late time window in Zhengzhou Central Hospital Affiliated to Zhengzhou University from May 2020 to June 2023,and were divided into 37 patients undergoing endovascular intervention(mechanical thrombectomy,balloon angioplasty,stenting)(intervention group)and 51 patients receiving medical management(medical group).The site of occlusion,admission National Institute of Health Stroke Scale(NIHSS)score,rate of ischemic core volume＞50 mL,rate of good prognosis in 90-d follow-up,incidence of symptomatic intracranial hemorrhage,90-d mortality rate,length of hospital stay,and length of ICU stay were compared between two groups.Results There were no significant differences in the age,gender ratio,previous medical history,site of occlusion,admission NIHSS score,and percentages of patients with smoking habits,＜48 h from onset,wake-up stroke and ischemic core volume＞50 mL between two groups.In intervention group,20 patients underwent mechanical thrombectomy,and 17 underwent mechanical thrombectomy combined with balloon angioplasty and/or stenting,with an immediate postoperative vascular re-canalization rate of 94.59％.The rate of good prognosis in 90-d follow-up was higher in intervention group(56.76％)than that in medical group(29.41％)(x2=6.633,P=0.010),and there were no significant differences in the 90-d mortality rate,incidence of symptomatic intracranial hemorrhage,length of hospital stay,and length of ICU stay between two groups(P＞0.05).Conclusion Endovascular intervention in the very late time window for anterior circulation LVO-AIS achieves a good result of immediate postoperative vascular re-canalization,and it has better 90-d nervous function than medical management,without increasing the risk of symptomatic intracranial hemorrhage or death.
acute ischemic strokevery late time windowanterior circulationlarge-vessel occlusionendovascular intervention
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