Background and Purpose- We aimed to determine if microemboli after endovascular thrombectomy correlate with unfavorable outcomes despite successful recanalization. Methods- This is a prospective multicenter study of consecutive patients with ischemic stroke and occlusion of anterior circulation vessels (terminal internal carotid or main trunk of the middle cerebral artery/first-order branch of the main trunk of the middle cerebral artery segments of middle cerebral artery) after successful thrombectomy (modified Treatment In Cerebral Ischemia grades 2b-3). Microembolic signals (MES) were assessed by 30 minutes of transcranial Doppler monitoring within 72 hours of the last-seen-well time. Major outcomes included modified Rankin Scale at 90 days and infarct volume on head computed tomography at 24 hours. We also assessed early outcomes based on National Institutes of Health Stroke Scale variation and recurrence of stroke, transient ischemic attack, or systemic embolism within 90 days. Results- Among 111 patients, MES were detected in 43 (39%), with a median rate of 4 counts/h (interquartile range 2-12). The occurrence of MES was not associated with a significant difference in modified Rankin Scale (ordinal shift analysis, adjusted odds ratio, 1.06 [95% CI, 0.48-2.34] P=0.85) nor in functional independence (modified Rankin Scale, 0-2: adjusted odds ratio, 0.52 [95% CI, 0.19-1.39] P=0.19). Patients with and without MES had similar infarct volumes (adjusted beta, 11.2 [95% CI, -46.6 to +22.9] P=0.51) on 24-hour computed tomography. MES did predict new embolic events (adjusted Cox hazard ratio, 6.78 [95% CI, 1.63-27.8] P=0.01). Conclusions- MES detected by transcranial Doppler following endovascular treatment of anterior circulation occlusions do not predict clinical or radiological outcome. However, such emboli are an independent marker of recurrent embolic events within 90 days.

中文翻译：

---

成功的血栓切除术后微栓塞不会影响预后，但可以预测新的栓塞事件。

背景和目的-我们的目的是确定尽管成功进行了再通，但血管内血栓切除术后的微栓塞是否与不良预后相关。方法-这是一项连续性缺血性脑卒中并阻塞前循环血管（大脑中动脉的终末颈内动脉或主干/大脑中动脉中主干一级支的连续患者）的前瞻性多中心研究。血栓切除术成功后（改良型脑缺血治疗2b-3级）。在最后一次看井时间的72小时内，通过30分钟的经颅多普勒监测，评估了微栓塞信号（MES）。主要结局包括在90天时修改过的Rankin量表和在24小时时进行头部计算机断层扫描的梗死体积。我们还根据美国国立卫生研究院卒中量表的变化和卒中复发，短暂性脑缺血发作或系统性栓塞在90天内进行了评估。结果-在111例患者中，检出MES的有43例（39％），中位率为4个计数/小时（四分位间距2-12）。MES的发生与改良兰金量表（常规移位分析，调整的优势比，1.06 [95％CI，0.48-2.34] P = 0.85）或功能独立性（改良兰金量表，0-2）无显着差异。 ：调整后的优势比为0.52 [95％CI，0.19-1.39] P = 0.19）。有和没有MES的患者在24小时计算机断层扫描上具有相似的梗塞体积（调整后的beta，11.2 [95％CI，-46.6至+22.9] P = 0.51）。MES确实预测了新的栓塞事件（调整的Cox危险比，6.78 [95％CI，1.63-27.8] P = 0.01）。结论：血管内治疗前循环闭塞后经颅多普勒检测到的MES无法预测临床或影像学结果。但是，此类栓子是90天内复发性栓子事件的独立标志物。