Outcome of mechanical thrombectomy for acute ischemic stroke and risk factors associated with mortality: A single center experience from Pakistan.

Abstract

Objective: To find out the outcomes of mechanical thrombectomy (MT) for acute ischemic stroke and risk factors associated with mortality. Study Design: Retrospective study. Setting: Department of Neurology, National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan. Period: October 2022 till January 2025. Methods: A total of 136 acute stroke patients management unit started functioning to caters patients requiring ntravenous thrombolysis (IVT) and MT. All patients who underwent MT for LVO from October 2022 till January 2025 were included. Inclusion criteria for MT was age >18 years, National Institutes of Health Stroke Scale (NIHSS) >6, ischemic cerebral signs on computed tomography (CT) scan by using Alberta Stroke Program Early CT Score (ASPECT) >6 and time from onset < 8 hours were included. Baseline demographics, risk factors, type of stroke, endovascular procedure and outcome were noted. Primary aim was to evaluate outcome (mortality and functional recovery). Secondary aim was predictors of mortality. Results: There were 136 patients who underwent MT, and baseline modified Rankin scale (MRS) and NIHSS were 4 and 14 respectively. Overall, 77.2% patients did achieve successful recanalization and we observed in hospital mortality of around 30.1%. Factors leading to poor recanalization were older age and high MRS score. Predictors of mortality were higher baseline MRS score, failed to achieve recanalization, procedural complication and reocclusion. Conclusion: This study demonstrates the important role of mechanical thrombectomy in the treatment of acute ischemic stroke. Older age, high MRS and ASPECT score remain factors associated with poor recanalization resulting in higher mortality.