Factors Associated With Multiple-Pass Thrombectomy In Acute Ischemic Stroke

Objective To investigate the relationship between multiple thrombectomy and outcome of patients with acute ischemic stroke caused by large artery occlusion received mechanical thrombectomy(MT),as well as the relevant factors affecting number of passes.Methods A retrospective study was carried out on 122 cases of acute stroke receiving thrombectomy with stent retriever from March 2013 to April 2018 in Shanghai No.9 People’s Hospital and Xinhua Hospital.According to the passes of stent retriever during thrombectomy,all patients were divided into less-pass group(LP group)(passes ≤2)and multiple-pass group(MP group)(passes > 2).Observed two groups of the patient’s age,sex,past medical history(history of stroke,hypertension,diabetes,atrial fibrillation,smoking and drinking),time of treatment,onset to puncture time,blood pressure before thrombolytic,NIHSS before thrombolytic,ASPECTS before thrombolytic,use of balloon catheter or intermediate catheter,vascular recanalization,incidence of cerebral hemorrhage,postoperative mortality and NIHSS score 7 days,mRS and mortality on 90 days,and so on.Analyzed the correlation between the multiple thrombectomy and prognosis,and used Logistic regression to evaluate the effects of various factors on the number of passes of stent retriever during thrombectomy.Results Logistic regression analysis showed that NIHSS score before thrombolysis and infarct location(internal carotid artery occlusion)were independent factors influencing the number of passes.The number of passes was not significantly correlated with improvement of symptoms and good outcome,but was positively correlated with artery recanalization rate and mortality.Conclusion The baseline NIHSS score,and the occlusion site are both predicting factors for the number of passes,and the number of passes affect the outcome.