Background:The recent success of several mechanical thrombectomy trials has resulted in a significant change in management for patients presenting with stroke.However,it is still unclear how to manage patients that pr...Background:The recent success of several mechanical thrombectomy trials has resulted in a significant change in management for patients presenting with stroke.However,it is still unclear how to manage patients that present with stroke and low National Institutes of Health Stroke Scale(NIHSS)≤5.We sought to review our experience of mechanical thrombectomy in patients with low NIHSS and confirmed M1 occlusion.Methods:We retrospectively analysed our prospectively maintained database of all patients undergoing mechanical thrombectomy between January 2008 and August 2016.We identified 41 patients with confirmed M1 occlusion and low NIHSS(≤5)on admission to our hospital.We collected demographic,radiological,procedural and outcome data.Results:The mean age of patients was 72±14,with 20 male patients.Associated medical conditions were common with hypertension seen in∼80%.Just over 50%presented with NIHSS 4 or 5.The average ASPECTS score on admission was 8.8(range 6–10),and the average clot length 10 mm.Angiographically Thrombolysis in Cerebral Infarction(TICI)≥2b was obtained in 87.8%of patients.7 patients had haemorrhage on follow-up,2 of which were symptomatic.Of 40 patients with 90-day follow-up,75%had modified Rankin Scale(mRS)score 0–2.There were 3 deaths at 90 days.Conclusions:Mechanical thrombectomy in patients with low NIHSS and proximal large vessel occlusion is technically possible and carries a high degree of success with good safety profile.Patients with low NIHSS and confirmed occlusion should be considered for mechanical thrombectomy.展开更多
文摘Background:The recent success of several mechanical thrombectomy trials has resulted in a significant change in management for patients presenting with stroke.However,it is still unclear how to manage patients that present with stroke and low National Institutes of Health Stroke Scale(NIHSS)≤5.We sought to review our experience of mechanical thrombectomy in patients with low NIHSS and confirmed M1 occlusion.Methods:We retrospectively analysed our prospectively maintained database of all patients undergoing mechanical thrombectomy between January 2008 and August 2016.We identified 41 patients with confirmed M1 occlusion and low NIHSS(≤5)on admission to our hospital.We collected demographic,radiological,procedural and outcome data.Results:The mean age of patients was 72±14,with 20 male patients.Associated medical conditions were common with hypertension seen in∼80%.Just over 50%presented with NIHSS 4 or 5.The average ASPECTS score on admission was 8.8(range 6–10),and the average clot length 10 mm.Angiographically Thrombolysis in Cerebral Infarction(TICI)≥2b was obtained in 87.8%of patients.7 patients had haemorrhage on follow-up,2 of which were symptomatic.Of 40 patients with 90-day follow-up,75%had modified Rankin Scale(mRS)score 0–2.There were 3 deaths at 90 days.Conclusions:Mechanical thrombectomy in patients with low NIHSS and proximal large vessel occlusion is technically possible and carries a high degree of success with good safety profile.Patients with low NIHSS and confirmed occlusion should be considered for mechanical thrombectomy.
