DefinePK

Research Objective

To determine the efficacy of mechanical thrombectomy in acute ischemic stroke as a predictor of functional recovery and mortality.

Methodology

A retrospective study conducted at Hayatabad Medical Complex, Peshawar, from June 2022 to May 2023, analyzing 354 patients who underwent mechanical thrombectomy (MT) for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Data collected included demographics, clinical history, comorbidities, radiological data, and therapeutic information. Stent retrievers and aspiration devices were used. Outcomes were assessed at 90 days post-procedure. Statistical analysis was performed using SPSS v27.

Methodology Flowchart

                        graph TD
    A[Patient Selection AIS with LVO] --> B[Data Collection from Medical Records];
    B --> C[Data AnalysisSPSS v27];
    C --> D[Identify Predictors of Functional Recovery and Mortality];
    D --> E[Assess Efficacy of Mechanical Thrombectomy];
    E --> F[Conclusion];                    

Discussion

Mechanical thrombectomy (MT) is effective in treating acute ischemic stroke (AIS) patients with large vessel occlusions (LVO). Predictors of functional recovery and mortality include patient demographics, clinical characteristics, and procedural details. Younger age, lower baseline NIHSS scores, and shorter onset-to-puncture times are associated with better outcomes. Successful revascularization is crucial for improving blood flow and relieving ischemia. Complications such as hemorrhagic transformation significantly increase mortality risk, highlighting the need for vigilant surveillance and timely intervention.

Key Findings

- 43% of patients experienced favorable functional recovery (mRS 0-2) at 90 days post-procedure.
- The mortality rate at 90 days was 22%.
- Patients with a door-to-puncture time of 60 minutes or less had a higher recovery rate (48%).
- Successful revascularization (TICI 2b-3) was associated with better recovery outcomes (50%) and lower mortality (17%).
- Older age (≥70 years), higher baseline NIHSS scores (≥15), and incomplete revascularization were associated with poorer functional outcomes and increased mortality.
- Complications like hemorrhagic transformation (15% of patients) had a high mortality rate (40%).

Conclusion

Mechanical thrombectomy significantly improves functional recovery in acute ischemic stroke patients, especially when performed promptly and with successful revascularization. Key predictors such as younger age, lower baseline NIHSS scores, and shorter onset-to-puncture times enhance the likelihood of positive outcomes, while incomplete revascularization and post-procedural complications increase mortality risks.

Fact Check

- The study analyzed 354 patients who underwent mechanical thrombectomy between June 2022 and May 2023.
- At 90 days post-procedure, 43% of patients achieved favorable functional recovery.
- The mortality rate at 90 days was 22%.

Mind Map