Effect of Solitaire FR Stent Thrombectomy Combined with the Suction Thrombus on the Clinical Effect and Prognosis of Acute Middle Cerebral Artery Occlusion

Abstract

To determine the curative effect and prognosis of Solitaire FR stent thrombectomy integrated with the suction thrombus on the treatment of acute middle cerebral artery occlusion (AMCAO). Based on the treatment, patients suffering from AMCAO were separated into the Solitaire FR group (Solitaire FR stent + suction thrombus) and suction group (suction thrombus). Modified thrombolysis in cerebral infarction grading, National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale score, and safety performance were compared between the two groups. The operation time in the suction group was obviously shorter than the Solitaire FR group ( P < 0.05 ). Significant differences were observed in the NIHSS scores 1 week and 4 weeks after the operation between the Solitaire FR group and the suction group ( P < 0.05 ). The NIHSS scores 1 week and 4 weeks after operation were significantly lower than those before operation ( P < 0.05 ). NIHSS scores 1 week after operation did not show obvious difference ( P > 0.05 ). The Solitaire FR group showed obvious lower NIHSS scores than the suction group 4 weeks after surgery ( P < 0.05 ). Statistically obvious difference in cerebral infarction grading of modified thrombolysis between the Solitaire FR group and the suction group were observed ( P < 0.05 ). The recanalization rate of the Solitaire FR group was obviously higher than the suction group ( P < 0.05 ). The difference in the monthly modified Rankin Scale score was obvious ( P < 0.05 ). The good prognosis rate of the Solitaire FR group was obviously higher than the suction group ( P < 0.05 ). No obvious differences in the incidence of internal bleeding, reocclusion, and 3-month postoperative mortality were observed ( P > 0.05 ). These results showed that the treatment of the Solitaire FR stent + suction thrombus in AMCAO patients has a good thrombus recanalization rate and is helpful in improving the prognosis and safety performance.

Outcomes of Patients With Atrial Fibrillation Following Thrombectomy for Stroke

“…An additional 2 studies were identified via expert recommendation. Finally, 10 studies with 6543 patients were determined to satisfy our inclusion criteria with the appropriate report of outcomes of interest (eFigure 1 in Supplement 1).…”

“…Of the 10 included studies, 8 studies used a retrospective design and 5 studies were multicenter studies. The size of the included studies ranged from 78 patients to 4169 patients.…”

“…The size of the included studies ranged from 78 patients to 4169 patients. Eight studies included in our analysis were determined to have good quality, while 2 studies were determined to have fair quality (eTable in Supplement 1). Patient characteristics, such as age, baseline NIHSS, use of intravenous thrombolytics, and comorbidities, are detailed in the Table.…”

“…Successful reperfusion rates (defined as TICI score 2b-3) were reported in 9 studies including 5577 AIS patients who underwent MT. Successful reperfusion rates were similar between patients with and without AF (OR, 1.11 [95% CI, 0.78-1.58]; P = .57); however, there was significant heterogeneity among studies ( I 2 = 56%; P = .02) (Figure 2A).…”

“…Ten studies with 6131 patients compared the rates of 90-day mortality between patients with and without AF. Mortality was significantly higher in the AF group (OR, 1.47 [95% CI, 1.12-1.92]; P = .005), with no significant heterogeneity observed ( I 2 = 42%; P = .08) (Figure 4).…”