Abstract

Objectives: The evidence of intra-arterial thrombectomy (IAT) in acute ischemic stroke with internal carotid artery (ICA) occlusion was less solid than with middle cerebral artery occlusion. In this study, we aimed to investigate the predictors of good functional outcome of acute ischemic stroke with ICA occlusion after IAT in order to identify which characteristics were more associated with good functional outcome.

Methods: From June 2016 to November 2018, all subjects who received IAT for acute stroke in three hospitals were enrolled. Those who had angiographic evidence of arterial occlusion not at ICA were excluded. Presence of tandem lesions was also excluded. After review of images, subjects without available non-enhanced CT or multiphase CTA were also excluded. The modified Rankin Scale (mRS) was used to separate all subjects into good outcome (mRS: 0-2) and poor outcome (mRS: 3-6) groups. Statistical analysis was used to find between group differences, including epidemiological data, clinical characters, imaging results, and IAT results.

Results: The final enrolled subjects were 32 cases. The median and interquartile range of age was 74.5 [16.5] years old and there were 15 men. As compared with the poor outcome group, significant differences in the good outcome group included younger age (p = 0.038), higher percentage of usage of antithrombotic agents (p = 0.019), higher percentage of good or intermediate collateral (p = 0.018), and good reperfusion result (p = 0.018).

Conclusion: The benefit of IAT in acute ICA occlusion was stronger in patients with better collateral and the success of IAT was also a key to good clinical outcome.