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Jozef Haring, Miroslav Mako, Ján Haršány, Georgi Krastev, Matúš Hoferica, Andrej Klepanec
(Department of Neurology, Faculty Hospital Trnava, Trnava, Slovakia)
Med Sci Monit 2021; 27:e930014
The purpose of this study was to evaluate outcomes of patients with mild stroke, defined by National Institutes of Health Stroke Scale (NIHSS) score <6, caused by large vessel occlusion treated with aspiration thrombectomy.
MATERIAL AND METHODS: Data from the endovascular stroke registry of our center were retrospectively analyzed. Anterior or posterior circulation strokes with NIHSS score <6 upon admission were analyzed. The assessment of a good clinical outcome (modified Rankin scale score 0-2) at day 90 was the primary endpoint. Symptomatic intracranial hemorrhage, defined in European Cooperative Acute Stroke Study grade III, and mortality at day 90 were the safety measures. A successful endovascular procedure was defined as a Thrombolysis in Cerebral Infarction (TICI) score of 2b or 3.
RESULTS: We included 27 patients treated with immediate mechanical thrombectomy, 19 (70.4%) in the anterior circulation and 8 (29.6%) in the posterior circulation. The mean age was 69.8±12.3 years and 40.7% were male. Thirteen patients (48.1%) received bridging intravenous thrombolysis before endovascular thrombectomy. Twenty-five patients (92.6%) underwent the direct aspiration first-pass technique “ADAPT” as the first choice of endovascular procedure. Successful recanalization was achieved in 25 patients (92.6%). Twenty-one patients (77.8%) had a good functional outcome at the 3-month follow-up, 1 (3.7%) symptomatic intracranial hemorrhage was observed, and 2 patients (7.4%) died.
CONCLUSIONS: Immediate aspiration thrombectomy may be a safe and feasible first-line treatment option in patients suffering from mild stroke due to large vessel occlusion in the anterior and posterior circulation.