The Relationship Between Periprocedural Thrombus Migration And Clinical Outcomes In Patients With Acute Large Vessel Occlusion

Objective: As one of the complications of mechanical thrombectomy(MT),periprocedural thrombus migration always leads to incomplete recanalization and poor outcomes.Because factors influencing its occurrence are largely unknown,this study addresses the relationship between periprocedural thrombus migration and clinical outcomes.Methods: We retrospectively analyzed the patients with anterior circulation acute large vessel occlusion stroke(ALVOS)who underwent mechanical thrombectomy in the stroke center of Yi Jishan Hospital of Wannan Medical College from May 2015 to December 2019.The baseline characteristics,procedural and clinical outcomes were collected.Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results: There were 302 patients included,of whom thrombus migration was identified in 80 patients,including 60 cases are of proximal migration.Cardiogenic stroke(OR: 2.722,95% CI: 1.367-5.418,P = 0.004)and clot burden score(CBS)(OR:0.849,95% CI: 0.745-0.968,P = 0.015)were independent risk factors of thrombus migration.Proximal migration(OR: 2.822,95% CI: 1.220-6.528,P = 0.015)was an independent risk factor of 90-day clinical outcome(OR: 2.822,95% CI: 1.220-6.528,P = 0.015),while the effect of distal migration on 90-day clinical outcome was not statistically significant(OR: 0.746,95% CI: 0.502-5.906,P = 0.388).Conclusion: Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in patients who underwent MT.The proximal migration is an independent risk factor for patents prognosis.,which has important clinical intervention value.