Objective:

To study factors associated with an unfavorable outcome in patients with large vessel occlusion ischemic stroke undergoing successful mechanical thrombectomy.

Background:

Mechanical thrombectomy (MT) has been effective in treating ischemic strokes due to large vessel occlusion (LVO). However, all patients with LVO who are deemed candidates for MT do not have successful rates of recanalization and a favorable outcome. Hence, we studied factors associated with an unfavorable outcome in patients undergoing successful MT.

Design/Methods:

We retrospectively analyzed sixty-two patients with LVO ischemic stroke undergoing MT. We included patients with anterior LVO strokes undergoing MT. Patient underwent CTA imaging upon arrival in the emergency room. Functional outcome was measured with discharge NIHSS and discharge mRS.

Results:

62 patients with LVO who underwent MT (age 68 ±15; 64.5 % female; admission NIHSS 16 ± 6). Patients were divided into two groups based on TICI score into those with unsuccessful (TICI 0-2a) and successful (TICI 2b/2c/3). In the unsuccessful group, patients had low ASPECTS on arrival and were not treated with thrombolysis prior to thrombectomy. They also had a higher NIHSS and mRS at discharge. In the successful group, 24 patients were associated with poor functional outcome, discharge NIHSS (p < 0.001) and mRS <3. These patents had higher admission NIHSS (p = 0.001).

Conclusions:

Lack of pre-treatment thrombolysis and high admission NIHSS scores were associated with poor functional outcome after successful mechanical thrombectomy.