Factors affecting prognosis in mechanical thrombectomy

Ischemic stroke is the most common type of stroke in the world. Our knowledge of endovascular treatment, which is an indispensable place in the treatment of acute ischemic stroke, has changed rapidly over the last 3 years. The successive positive results following the disappointing and negative initial studies have now irrevocably strengthened the place of endovascular therapy. In this study; We aimed to evaluate the effectiveness of the mechanical thrombectomy procedure and the factors affecting the successful outcome in the treatment of acute ischemic stroke. In the study, patients who had undergone endovascular treatment due to acute ischemic stroke in Fırat University Hospital between May 2016 and May 2019, demographic characteristics, application time, NIHS score, application clinic, application blood sugar and blood pressure, pre-procedure CT angio collateral status, post-procedure recanalization rates, parenchymal hemorrhage presence, TOAST classification and 3rd-6th month modified Rankin scores were evaluated retrospectively and recorded. CT Angiographic collateral conditions of the patients, which were taken before the mechanical thrombectomy procedure, were evaluated based on the mTAN score. Chi-square statistical analysis was used to analyze the relationship between collateral score and positive clinical outcome (mRankinS 0-2) and success in ravascularization. In 23 (59%) of 39 patients, successful (TICI 2b-3) recanalization was achieved after the procedure. 24 (61.5%) patients had good collateral TAN (2-3). 82% (n: 19) of 23 patients who were well recanalized had TAN (2-3) good collateral. A significant correlation was found between patients with good collateral evaluated according to the mTAN score and the success of recanalization (P = 0.012 <0.0) At the same time, the patients with mTAN score at 6th month follow-up by evaluating the mRANKIN score of the patients had higher functional independence rates (p: 0.007 <0.05) Atrial fibrillation was the only case in which there was a significant relationship between the chronic diseases accompanying patients and their collateral status. As a result, patients with acute colchemia acute ischemic stroke on CT Angiography have successful recanalization and functional independence. Keywords: Endovascular treatment, cerebral collateral condition, good clinical outcome