INTRODUCTION Mechanical thrombectomy (MT) for acute ischemic stroke has become a standard therapy, and the recanalization rate has significantly improved. However, some cases of unsuccessful recanalization still occur. We aimed to clarify patient factors associated with unsuccessful recanalization after MT for acute ischemic stroke. METHODS This was a single-center, retrospective study of 119 consecutive patients with anterior circulation acute ischemic stroke who underwent MT at our hospital between April 2015 and March 2019. Successful recanalization after MT was defined as modified Treatment in Cerebral Ischemia (mTICI) grade 2b or 3, and unsuccessful recanalization was defined as mTICI grades 0-2a. Several factors were analyzed to assess their effect on recanalization rates. RESULTS Successful recanalization was achieved in 88 patients (73.9%). The univariate analysis showed that female sex (38.6 vs. 67.7%, p = 0.007), a history of hypertension (53.4 vs. 83.9%, p = 0.003), and a longer time from groin puncture to recanalization (median 75 vs. 124 min, p < 0.001) were significantly associated with unsuccessful recanalization. The multivariate analysis confirmed that female sex (OR 3.18; 95% CI 1.12-9.02, p = 0.030), a history of hypertension (OR 4.84; 95% CI 1.32-17.8, p = 0.018), M2-3 occlusion (OR 4.26; 95% CI 1.36-13.3, p = 0.013), and the time from groin puncture to recanalization (per 10-min increase, OR 1.22; 95% CI 1.09-1.37, p < 0.001) were independently associated with unsuccessful recanalization. CONCLUSION Female sex and a history of hypertension might be predictors of unsuccessful recanalization after MT for anterior circulation acute ischemic stroke. Further studies are needed to fully evaluate predictors of recanalization.

中文翻译：

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机械血栓切除术治疗急性缺血性中风再通失败的相关因素。

引言机械血栓切除术（MT）已成为急性缺血性卒中的标准治疗方法，并且再通率已显着提高。但是，仍会发生某些再通失败的情况。我们旨在阐明与MT导致急性缺血性卒中后再通失败相关的患者因素。方法这是一项对2015年4月至2019年3月在我院接受MT的连续119例前循环急性缺血性卒中患者进行的单中心回顾性研究。MT术后成功的再通定义为改良的脑缺血（mTICI）2b级治疗或3，再通失败则定义为mTICI 0-2a级。分析了几个因素以评估它们对再通率的影响。结果88例患者成功实现了再通（73。9％）。单变量分析显示，女性（38.6比67.7％，p = 0.007），高血压病史（53.4比83.9％，p = 0.003）以及从腹股沟穿刺到再通的时间更长（中位数为75 vs 124）。 min，p <0.001）与重新通气不成功显着相关。多元分析证实女性（OR 3.18; 95％CI 1.12-9.02，p = 0.030），有高血压病史（OR 4.84; 95％CI 1.32-17.8，p = 0.018），M2-3闭塞（OR 4.26） ； 95％CI 1.36-13.3，p = 0.013），以及从腹股沟穿刺到再通的时间（每增加10分钟，或增加1.22； 95％CI 1.09-1.37，p <0.001）独立地与再通失败相关。结论女性和高血压病史可能是前循环急性缺血性卒中MT后再通失败的预示因素。