Efficacy Analysis Of Mechanical Thrombectomy In Late Time Window For Acute Anterior Circulation Ischemic Stroke

Objective:To investigate the efficacy and safety of endovascular therapy in patients with acute anterior circulation large vessel occlusion in late time window as assessed by Mistar software.Methods:A total of 88 patients with acute anterior circulation large vessel occlusion and stroke who underwent mechanical thrombectomy in our hospital from January 2021 to November 2021 were retrospectively included.According to the onset time-femoral artery puncture time,88 patients were divided into the time window group(onset-femoral artery puncture time≤6h,53 cases)and the late-time window group(onset-femoral artery puncture time>6h,35 cases)),the baseline data such as age and gender,risk factors for cerebrovascular disease,National Institutes of Health Stroke Scale(NIHSS)score on admission,preoperative Alberta Stroke Project Early CT(ASPECT)score,and vascular The occlusion site,the presence or absence of intravenous thrombolysis,the use or not of tirofiban,the operation time node,the vascular recanalization grade,the anesthesia method,and the blood glucose level were compared.Successful recanalization was defined as modified Thrombolysis in Cerebral Infarction(mTICI)grade 2b or 3 .At90 days after operation,a modified Rankin scale(mRS)score of 0 to 2 was regarded as a good prognosis,and a(mRS)score of 3 to 6 was regarded as a poor prognosis.Results:(1)There were no significant differences in age,gender,hypertension,diabetes history,smoking,drinking history,admission NIHSS score,ASPECT score,and blood sugar level between the two groups.In the time window group,the incidence of atrial fibrillation in the time window group was higher than that in the time window group,and the difference between the two groups was statistically significant;(2)There was no significant difference in the vascular occlusion site and mTICI grade between the two groups;The onset-admission time,admission-femoral artery puncture time,femoral artery puncture-recanalization time,and symptom onset to recanalization time of patients within the window group were all shorter than those of the overtime window group,and the differences between groups were statistically significant.(3)There was no statistically significant difference in the incidence of symptomatic intracranial hemorrhage(symptomatic intracranial Hemorrhage sICH)between the two groups at 24 hours after surgery;there was no significant difference in the rate of good 90 functional prognosis and the mortality rate between the two groups.Conclusion:The efficacy and safety of endovascular therapy in patients with large vessel occlusion beyond the time window after evaluation by Mistar software are similar to those within the time window group,no significant increase in symptomatic intracranial hemorrhage and death.