机构：[1]Interventional Neuroradiology Center , Beijing Tiantan Hospital, Capital Medical University[2]China National Clinical Research Center for Neurological Diseases , Beijing Tiantan Hospital, Capital Medical University[3]Department of Neurology, China National Clinical Research Center for Neurological Diseases, Tiantan Clinical Trial and Research Center for Stroke , Beijing Tiantan Hospital, Capital Medical University[4]Department of Neurosurgery, University of South Florida .[5]Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany .[6]Department of Interventional Neuroradiology, Langfang Changzheng Hospital, China .[7]Department of Interventional Neuroradiology, Liaocheng Third People’s Hospital, China .[8]Department of Neurosurgery, The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, China .[9]Department of Neurology, Second Affiliated Hospital of Nanjing Medical University, China .[10]Department of Interventional Radiology, Fengrun District People’s Hospital of Tangshan City, China .[11]Department of Neurology, SiPing Central People’s Hospital, China .[12]Department of Neurology, Yijishan Hospital of Wannan Medical College, China .[13]Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, China .[14]Department of Neurology, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, China .[15]Department of Neurosurgery, The First Hospital of Shijiazhuang, China .[16]Department of Neurology, Shenzhen Hospital of Southern Medical University, China .南方医科大学深圳医院深圳市康宁医院深圳医学信息中心[17]Department of Neurology, The People’s Hospital of Longhua, China .深圳市龙华区人民医院深圳医学信息中心[18]Department of Neurology, Jingjiang People’s Hospital, The Seventh Affiliated Hospital of Yangzhou University, China .[19]Department of Neurology, Hubei Third People’s Hospital, China .[20]Department of Neurology, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, China .[21]Department of Neurosurgery, Tianjin TEDA Hospital, China .[22]Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, China .[23]Department of Neurology, Taiyuan Central Hospital, China .[24]Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, China .[25]Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, China .[26]Department of Neurosurgery, Wenling First People’s Hospital, China .[27]Department of Neurology, The Second Affiliated Hospital of Xi’an Jiaotong University, China .[28]Department of Internal Neurology, The First People’s Hospital of Yulin, China .[29]Department of Neurosurgery, Zhenjiang First People’s Hospital, China .[30]Department of Neurology, Qitaihe Coal General Hospital, China .[31]Stroke Center, People’s Hospital of Tangshan City, China .[32]Department of Neurology, Affiliated Hospital Guilin Medical University, China .[33]Department of Neurology, The Affiliated Hospital of Hebei University, China .河北大学附属医院[34]Department of Neurointervetion, Beijing Anzhen Hospital, Capital Medical University, China .首都医科大学附属安贞医院[35]Department of Medicine and Therapeutics, Chinese University of Hong Kong, China .[36]Department of Neurology, University of California .[37]Beijing Tiantan Hospital, Capital Medical University, China .首都医科大学附属天坛医院
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.
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.
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]).
Despite distinct characteristics in the Chinese population, favorable outcome of EVT can be achieved in clinical practice in China. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03370939.
基金：
This study was supported by the National Key Research and Development Program of China (2016 YFC1301500).
第一作者机构：[1]Interventional Neuroradiology Center , Beijing Tiantan Hospital, Capital Medical University
共同第一作者：
通讯作者：
通讯机构：[37]Beijing Tiantan Hospital, Capital Medical University, China .[*1]Beijing Tiantan Hospital, Capital Medical University, No.119 S 4th Ring Rd W, Fengtai District, Beijing 100070, China
推荐引用方式(GB/T 7714)：
Jia Baixue,Ren Zeguang,Mokin Maxim,et al.Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China: A Real-World Nationwide Registry.[J].STROKE.2021,52(4):1203-1212.doi:10.1161/STROKEAHA.120.031869.
APA：
Jia Baixue,Ren Zeguang,Mokin Maxim,Burgin W Scott,Bauer Clayton T...&Miao Zhongrong.(2021).Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China: A Real-World Nationwide Registry..STROKE,52,(4)
MLA：
Jia Baixue,et al."Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China: A Real-World Nationwide Registry.".STROKE 52..4(2021):1203-1212
医学