Objectives

To identify whether intracranial atherosclerotic disease large vessel occlusion strokes differ compared to embolic large vessel occlusion strokes in angiographic response to mechanical thrombectomy and clinical course.

Methods

Retrospective analysis of acute ischemic stroke patients with large vessel occlusion, due to intracranial atherosclerotic disease or embolic etiology, who underwent mechanical thrombectomy in a primary stroke center from 11/2015 to 4/2018. We categorized patients into intracranial atherosclerotic disease or embolic large vessel occlusion based on the procedural findings. We compared pretreatment, procedural variables, and post-procedural outcomes.

Results

Ninety-five patients were included, 13 with intracranial atherosclerotic disease large vessel occlusion strokes and 82 with embolic large vessel occlusion strokes. Between the two groups, there was no statistically significant difference in angiographic success (100% for intracranial atherosclerotic disease and 89% for embolic large vessel occlusion strokes); first pass success (38% for intracranial atherosclerotic disease and 34% for embolic large vessel occlusion strokes); puncture-to-first-pass time; puncture-to-recanalization time (68 minutes for intracranial atherosclerotic disease and 62 minutes for embolic large vessel occlusion strokes); number of passes; or clinical outcomes. Intracranial angioplasty was performed in 6 (46%) of intracranial atherosclerotic disease large vessel occlusion patients, and in 5 (6%) of embolic large vessel occlusion patients (p < 0.0001).

Conclusions

Similar angiographic success and procedural time metrics are achievable with intracranial atherosclerotic disease large vessel occlusion and embolic large vessel occlusion therapy. This occurred with more frequent intracranial angioplasty for intracranial atherosclerotic disease large vessel occlusion strokes.

中文翻译：

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机械性血栓切除术治疗颅内动脉粥样硬化性疾病大血管阻塞性中风的血管造影和临床反应。

目标

为了确定颅内动脉粥样硬化疾病大血管闭塞性中风与栓塞性大血管闭塞性中风在对机械血栓切除术和临床过程的血管造影反应中是否不同。

方法

回顾性分析由于颅内动脉粥样硬化疾病或栓塞病因导致的大血管闭塞的急性缺血性中风患者，他们于11/2015至4/2018在原发性中风中心接受了机械血栓切除术。我们根据手术结果将患者分为颅内动脉粥样硬化性疾病或栓塞性大血管闭塞。我们比较了治疗前，过程变量和术后结果。

结果

包括95名患者，其中13例颅内动脉粥样硬化疾病大血管闭塞性中风，82例栓塞性大血管闭塞性中风。两组之间的血管造影成功率无统计学差异（颅内动脉粥样硬化疾病为100％，栓塞性大血管阻塞性卒中为89％）。首过成功（颅内动脉粥样硬化疾病为38％，栓塞大血管阻塞性卒中为34％）；穿刺至首次通过时间；穿刺到再穿管的时间（颅内动脉粥样硬化疾病为68分钟，栓塞大血管阻塞性卒中为62分钟）；通过次数；或临床结果。6例（46％）颅内动脉粥样硬化性疾病大血管阻塞患者进行了颅内血管成形术，

结论

颅内动脉粥样硬化疾病大血管闭塞和栓塞大血管闭塞治疗可达到相似的血管造影成功率和手术时间指标。对于颅内动脉粥样硬化性疾病大血管闭塞性卒中，颅内血管成形术的发生频率更高。