KẾT QUẢ NGẮN HẠN CỦA CAN THIỆP LẤY HUYẾT KHỐI ĐIỀU TRỊ NHỒI MÁU NÃO CẤP DO TẮC MẠCH MÁU LỚN TUẦN HOÀN TRƯỚC

Abstract

Background: Acute ischemic stroke is one of the leading causes of disability and mortality. Endovascular thrombectomy in acute ischemic stroke patients within the extended window has been shown to improve clinical outcomes and reduce mortality rates compared to medical management alone; however, its efficacy and safety profile vary among different patient populations. Objectives: To describe the magnetic resonance imaging characteristics in patients with acute ischemic stroke due to anterior circulation large vessel occlusion presenting after 6 hours from symptom onset, and to evaluate the outcomes and associated factors of mechanical thrombectomy in these patients. Materials and methods: A cross-sectional descriptive study was conducted on 41 patients with acute ischemic stroke due to anterior circulation large vessel occlusion, with a DWI-ASPECTS of 3 to 5, who were admitted within the 6-to-24-hour window after onset at S.I.S Can Tho International General Hospital from January 2025 to January 2026. The primary endpoint was the rate of successful recanalization. Secondary endpoints included the rates of early neurological improvement, symptomatic intracranial hemorrhage, decompressive craniectomy, and in-hospital mortality. Results: Among 41 patients, the successful recanalization rate was 87.8%. The rate of early neurological improvement was 9.8%, symptomatic intracranial hemorrhage occurred in 12.2%, decompressive craniectomy was 9.8%, and in-hospital mortality was 4.9%. Conclusions: Endovascular thrombectomy in patients with DWIASPECTS of 3-5 presenting after 6 hours from onset demonstrates a high rate of successful recanalization, along with low rates of decompressive craniectomy and in-hospital mortality.