This observational study was designed for observe the cerebral hemodynamics and dynamic cerebral autoregulation (dCA) after endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) patients. And analysis the relationship between the dCA damage degree and hemorrhage transformation (HT) and clinical outcome. Patients: patients with AIS caused by middle cerebral artery or internal carotid artery occlusion who accepted EVT. dCA Examination: dCA examinations were performed at 24 hours, 48 hours, 72 hours, and 5 days after EVT. The objectives of the study were as follows: The changes of cerebral hemodynamics and parameters of dCA in different time periods after EVT were analyzed. So as to determine the correlation between hemodynamics and dCA change and HT and clinical outcome after EVT and to explore the predictors of HT and adverse clinical outcomes.
Part of the data from March 2022 to March 2022 was obtained, but it was still need more data and need a one-year follow-up of the data. Therefore, this is a 4 years prospective cohort study. The objectives of the study were as follows: This observational study was designed for observe the cerebral hemodynamics and dynamic cerebral autoregulation (dCA) after endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) patients. And analysis the relationship between the dCA damage degree and hemorrhage transformation (HT) and clinical outcomes. To explore the predictors of HT and adverse clinical outcomes. A. To enroll 300 cases of patients with AIS caused by middle cerebral artery or internal carotid artery occlusion who accepted EVT. B. dCA examinations were performed at 24 hours, 48 hours, 72 hours, and 5 days after EVT. C. The computed tomography was performed to distinguish if the patients have HT within 7 days after EVT. D. Utilizing the modified Rankin Scale (mRS), the clinical prognosis was assessed 3 months and 1 year after stroke. The outcomes were dichotomized according to the mRS score: favorable outcome (mRS ≤ 2) and unfavorable outcome (mRS: 3-6). During the telephone call follow-up, the clinician was unaware of any pertinent clinical or dCA information while examining each mRS score. E. All tests are non-invasive.
Study Type
OBSERVATIONAL
Enrollment
300
All individuals were anesthetized, with local or general anesthesia dependent on the cooperation level of the patient. During the procedure, it was mandatory to administer intravenous heparin to maintain the activated clotting time between 250 and 300 s, except for subjects who received intravenous alteplase. The procedures were performed through the femoral artery. The selection of stent retriever type and size, along with any required devices, such as guide wires and catheters, as well as the intervention strategy, was at the interventionists' discretion.
Department of Vascular Ultrasonography, Xuanwu Hospital of Capital Medical University
Beijing, Beijing Municipality, China
The occurrence of hemorrhage transformation
The AIS patients have hemorrhage transformation detected by head computed tomography scans within 7 days after EVT
Time frame: 7 days
Patients without hemorrhage transformation
The AIS patients do not have hemorrhage transformation detected by head computed tomography scans within 7 days after EVT
Time frame: 7 days
The occurrence of unfavorable outcome
The modified Rankin Scale (mRS) score was 3-6 of AIS patients with EVT after 3 months.
Time frame: 3 months
The occurrence of favorable outcome
The modified Rankin Scale (mRS) score ≤2 of AIS patients with EVT after 3 months.
Time frame: 3 months
The occurrence of long-term unfavorable outcome
The modified Rankin Scale (mRS) score was 3-6 of AIS patients with EVT after 1 year.
Time frame: 1 year
The occurrence of long-term favorable outcome
The modified Rankin Scale (mRS) score ≤2 of AIS patients with EVT after 1 year.
Time frame: 1 year
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