Complications Clinical Analysis Of Mechanical Thrombectomy For Acute Ischemic Stroke

Objective In this study,the causes of complications of mechanical thrombectomy(MT)were analyzed,and the experiences were summarized in order to improve the safety of surgery and reduce complications incidence.Method The data of 115 patients with acute ischemic stroke(AIS)treated with Solitaire AB stent thrombectomy in the Department of Neurology,Baotou Central Hospital from January 2013 to December 2016 were collected(Including MT after intravenous thrombolysis(IT),MT combined with arterial thrombolysis,balloon dilation and stent implantation).The population characteristics of MT and its complications(gender,age,smoking history,and basic diseases),NIHSS score distribution,characteristics of time window from onset to interventional therapy,type of complications and vascular distribution were analyzed for statistics.The comparison of the differences in the incidence of complications in different sites of thrombectomy was made for statistics.The complications of pure MT and compound thrombectomy were statistically analyzed and compared.The annual incidence and mortality of MT from 2013 to 2016 were statistically compared,and analyzed if there was a statistical difference.Results In 115 cases of MT,complications occurred in 41 cases(35.65%).(1)There was no significant difference between gender,age and complications(P>0.05);In basic diseases,there was a correlation between the past TIA and the occurrence of complications(P<0.05),and the others are greater than0.05.There were some differences between different treatment time windows and complications.(P<0.05)(2)The incidences of complications of different occluded vessels were:Middle cerebral artery(MCA)44.44%(24/54),Internal carotid artery(ICA)31.82%(7/22),Basilar artery(BA)22.73%(5/22),Common carotid artery(CCA)50%(1/2),VA-BA series 33.33%(2/6),ICA-MCA series 40%(2/5).There was no significant difference in the incidence of complications of different occluded vessels(P>0.05).(3)The incidence of complications in the pure MT group was 35%(14/40),and the incidence in the compound thrombectomy group was 36%(27/75).There was no significant difference in the incidence of complications between the two groups(P>0.05).(4)The incidence of complications of MT in different years:2013: 66.67%(10/15),2014: 71.43%(5/7),2015: 25.93%(7/27),2016: 28.79%(19/66).The incidences of complications in 2015 and 2016 were significantly lower than that of the former two years.Statistical analysis showed significant differences between different years(P<0.05).The mortality of MT in different years:2013: 20%(3/15),2014:14.29%(1/7),2015: 18.52%(5/27),2016: 13.64%(9/66),there was no significant difference in mortality of different years,P>0.05.Conclusion(1)patients with previous TIA have a high probability of complications,and the others showed no effect on the occurrence of complications of MT.(2)The incidence of complications of anterior circulation MT was high,but there was no significant difference in the incidence of complications between anterior and posterior circulation thrombectomy.(3)There was no significant difference between the two groups in the incidence of complications,and the safety was similar.(4)With the increase of the number of cases,the improvement of experience and technology,the incidence and mortality of MT are gradually reduced,and the safety is gradually improved.