Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China A Real-World Nationwide Registry

被引：107

作者：

Jia, Baixue ^{[2
]}

Ren, Zeguang ^{[5
]}

Mokin, Maxim ^{[5
]}

Burgin, W. Scott ^{[5
]}

Bauer, Clayton T. ^{[5
]}

Fiehler, Jens ^{[6
]}

Mo, Dapeng ^{[2
]}

Ma, Ning ^{[2
]}

Gao, Feng ^{[2
]}

Huo, Xiaochuan ^{[2
]}

Luo, Gang ^{[2
]}

Wang, Anxin ^{[3
]}

Pan, Yuesong ^{[3
]}

Song, Ligang ^{[2
]}

Sun, Xuan ^{[2
]}

Zhang, Xuelei ^{[2
]}

Gui, Liqiang ^{[7
]}

Song, Cunfeng ^{[8
]}

Peng, Ya ^{[9
]}

Wu, Jin ^{[10
]}

Zhao, Shijun ^{[11
]}

Zhao, Junfeng ^{[12
]}

Zhou, Zhiming ^{[13
]}

Li, Yongli ^{[14
]}

Jing, Ping ^{[15
]}

Yang, Lei ^{[16
]}

Liu, Yajie ^{[17
]}

Zhao, Qingshi ^{[18
]}

Liu, Yan ^{[19
]}

Peng, Xiaoxiang ^{[20
]}

Gao, Qingchun ^{[21
]}

Guo, Zaiyu ^{[22
]}

Chen, Wenhuo ^{[23
]}

Li, Weirong ^{[24
]}

Cheng, Xiaojiang ^{[25
]}

Xu, Yun ^{[26
]}

Zhang, Yongqiang ^{[27
]}

Zhang, Guilian ^{[28
]}

Lu, Yijiu ^{[29
]}

Lu, Xinyu ^{[30
]}

Wang, Dengxiang ^{[31
]}

Wang, Yan ^{[32
]}

Li, Hao ^{[33
]}

Ling, Li ^{[34
]}

Peng, Guangge ^{[2
]}

Zhang, Jingyu ^{[2
]}

Zhang, Kai ^{[2
]}

Li, Shuo ^{[2
]}

Qi, Zhongqi ^{[2
]}

Xu, Haifeng ^{[2
]}

机构：

[1] Capital Med Univ, Beijing Tiantan Hosp, 119 S 4th Ring Rd W, Beijing 100070, Peoples R China

[2] Capital Med Univ, Beijing Tiantan Hosp, Intervent Neuroradiol Ctr, Beijing, Peoples R China

[3] Capital Med Univ, Beijing Tiantan Hosp, China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China

[4] Capital Med Univ, Beijing Tiantan Hosp, China Natl Clin Res Ctr Neurol Dis, Dept Neurol,Tiantan Clin Trial & Res Ctr Stroke, Beijing, Peoples R China

[5] Univ S Florida, Dept Neurosurg, Tampa, FL 33620 USA

[6] Univ Med Ctr Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, Hamburg, Germany

[7] Langfang Changzheng Hosp, Dept Intervent Neuroradiol, Langfang, Peoples R China

[8] Liaocheng Third Peoples Hosp, Dept Intervent Neuroradiol, Liaocheng, Shandong, Peoples R China

[9] Soochow Univ, Affiliated Hosp 3, Peoples Hosp Changzhou 1, Dept Neurosurg, Suzhou, Peoples R China

[10] Nanjing Med Univ, Affiliated Hosp 2, Dept Neurol, Nanjing, Peoples R China

[11] Fengrun Dist Peoples Hosp Tangshan City, Dept Intervent Radiol, Tangshan City, Peoples R China

[12] SiPing Cent Peoples Hosp, Dept Neurol, Siping, Peoples R China

[13] Wannan Med Coll, Dept Neurol, Yijishan Hosp, Wuhu, Peoples R China

[14] Harbin Med Univ, Affiliated Hosp 2, Dept Neurosurg, Harbin, Peoples R China

[15] Huazhong Univ Sci & Technol, Wuhan Cent Hosp, Tongji Med Coll, Dept Neurol, Wuhan, Peoples R China

[16] First Hosp Shijiazhuang, Dept Neurosurg, Shijiazhuang, Hebei, Peoples R China

[17] Southern Med Univ, Dept Neurol, Shenzhen Hosp, Guangzhou, Peoples R China

[18] Peoples Hosp Longhua, Dept Neurol, Shenzhen, Peoples R China

[19] Yangzhou Univ, Affiliated Hosp 7, Jingjiang Peoples Hosp, Dept Neurol, Yangzhou, Jiangsu, Peoples R China

[20] Hubei Third Peoples Hosp, Dept Neurol, Wuhan, Peoples R China

[21] Guangzhou Med Univ, Affiliated Hosp 2, Inst Neurosci, Dept Neurol, Guangzhou, Peoples R China

[22] Tianjin TEDA Hosp, Dept Neurosurg, Tianjin, Peoples R China

[23] Fujian Med Univ, Zhangzhou Affiliated Hosp, Dept Neurol, Fuzhou, Peoples R China

[24] Taiyuan Cent Hosp, Dept Neurol, Taiyuan, Peoples R China

[25] Xinjiang Med Univ, Affiliated Hosp 1, Dept Neurosurg, Urumqi, Peoples R China

[26] Nanjing Univ, Med Sch, Affiliated Drum Tower Hosp, Dept Neurol, Nanjing, Peoples R China

[27] Wenling First Peoples Hosp, Dept Neurosurg, Taizhou, Peoples R China

[28] Xi An Jiao Tong Univ, Affiliated Hosp 2, Dept Neurol, Xian, Peoples R China

[29] First Peoples Hosp Yulin, Dept Internal Neurol, Yulin, Peoples R China

[30] Zhenjiang First Peoples Hosp, Dept Neurosurg, Zhenjiang, Jiangsu, Peoples R China

[31] Qitaihe Coal Gen Hosp, Dept Nem, Qitaihe, Peoples R China

[32] Peoples Hosp Tangshan City, Stroke Ctr, Tangshan City, Peoples R China

[33] Guilin Med Univ, Affiliated Hosp, Dept Neurol, Guilin, Peoples R China

[34] Hebei Univ, Affiliated Hosp, Dept Neurol, Baoding, Peoples R China

[35] Capital Med Univ, Beijing Anzhen Hosp, Dept Neurointervet, Beijing, Peoples R China

[36] Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China

[37] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA

来源：

STROKE | 2021年 / 52卷 / 04期

关键词：

functional status; ischemic stroke; logistic models; registries; reperfusion; ACUTE ISCHEMIC-STROKE; TISSUE-PLASMINOGEN ACTIVATOR; MECHANICAL THROMBECTOMY; INTRACRANIAL ATHEROSCLEROSIS; ARTERY-OCCLUSION; OUTCOMES; THERAPY; GUIDELINES; STENOSIS;

D O I：

10.1161/STROKEAHA.120.031869

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose: The benefit of endovascular treatment (EVT) for large vessel occlusion in clinical practice in developing countries like China needs to be confirmed. The aim of the study was to determine whether the benefit of EVT for acute ischemic stroke in randomized trials could be generalized to clinical practice in Chinese population. Methods: We conducted a prospective registry of EVT at 111 centers in China. Patients with acute ischemic stroke caused by imaging-confirmed intracranial large vessel occlusion and receiving EVT were included. The primary outcome was functional independence at 90 days defined as a modified Rankin Scale score of 0 to 2. Outcomes of specific subgroups in the anterior circulation were reported and logistic regression was performed to predict the primary outcome. Results: Among the 1793 enrolled patients, 1396 (77.9%) had anterior circulation large vessel occlusion (median age, 66 [56-73] years) and 397 (22.1%) had posterior circulation large vessel occlusion (median age, 64 [55-72] years). Functional independence at 90 days was reached in 45% and 44% in anterior and posterior circulation groups, respectively. For anterior circulation population, underlying intracranial atherosclerotic disease was identified in 29% of patients, with higher functional independence at 90 days (52% versus 44%; P=0.0122) than patients without intracranial atherosclerotic disease. In the anterior circulation population, after adjusting for baseline characteristics, procedure details, and early outcomes, the independent predictors for functional independence at 90 days were age <66 years (odds ratio [OR], 1.733 [95% CI, 1.213-2.476]), time from onset to puncture >6 hours (OR, 1.536 [95% CI, 1.065-2.216]), local anesthesia (OR, 2.194 [95% CI, 1.325-3.633]), final modified Thrombolysis in Cerebral Infarction 2b/3 (OR, 2.052 [95% CI, 1.085-3.878]), puncture-to-reperfusion time <= 1.5 hours (OR, 1.628 [95% CI, 1.098-2.413]), and National Institutes of Health Stroke Scale score 24 hours after the procedure <11 (OR, 9.126 [95% CI, 6.222-13.385]). Conclusions: Despite distinct characteristics in the Chinese population, favorable outcome of EVT can be achieved in clinical practice in China. Registration: URL: ; Unique identifier: NCT03370939.

引用

页码：1203 / 1212

页数：10

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