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In patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO) , restoration of adequate cerebral perfusion is the main goal of endovascular therapy (EVT), which reduces disability and mortality by limiting the growth of infarcts (IG) .
However, although more than 80% of patients achieved complete recanalization (Expanded Thrombolysis Scale for Cerebral Infarction [eTICI] score 2b-2c-3), less than half of AIS-LVO patients achieved a 3-month good Result .
Recently, it has been discovered that the number of blood clot retrievals (Repeated Clot Retrieval, CRA) is a sign of clinical results, and has nothing to do with the success rate of final recanalization.
Increasing CRA has an adverse effect on the 3-month functional outcome .
In addition, obtaining complete recanalization at the first CRA is associated with favorable results and reduced mortality
.
The adverse effect of repeated CRA on the functional outcome is not direct and has not been explained
Causes emboli to enter a new (initially unaffected) area (emboli to new territory, ENT), which is related to IG and may explain the adverse effects of CRA on functional results
They extracted data from two pooled multi-center prospective registries of patients with anterior AIS-LVO who underwent continuous mechanical thrombectomy (MT) treatment from January 2016 to January 2019
.
Patients who achieved successful recanalization by diffusion-weighted imaging (DWI) before treatment and 24 hours after treatment were included, defined as the Expanded Cerebral Infarction Thrombolysis Scale (eTICI) score of 2b, 2C, or 3
thrombus
A total of 419 patients who successfully recanalized were included
.
They found that the occurrence of ENT is closely related to the increase of CRA (ρ=0.
73, p=10-4)
The occurrence of ENT is closely related to the increase of CRA (ρ=0.
73, p=10-4)
The important significance of this study is that it has been found that in acute stroke, the increase in the number of CRA is related to the increase in the ENT rate and the increase in the amount of IG.
Even if the recanalization is successful, it will also affect the functional outcome
.
Even if the recanalization is successful, it will affect the functional outcome
.
The increase in the number of CRA is related to the increase in the ENT rate and the increase in the amount of IG.
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