Characteristics, clinical profiles, and outcomes of patients undergoing endovascular thrombectomy: A retrospective study, Saudi Arabia.

BACKGROUND

Stroke is a significant contributor to both mortality and compromised physical function. Endovascular thrombectomy (EVT) is now the recognized standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO), especially when favorable brain images are evident within 24 h of symptom onset. This study elucidated the characteristics, clinical profiles, and outcomes of patients who underwent EVT for AIS.

METHODOLOGY: In this retrospective record-based cohort study, we reviewed the medical records of individuals who underwent EVT for AIS at King Fahad General Hospital in Jeddah, Saudi Arabia. The study, conducted from July 2022 through October 2023, encompassed a comprehensive analysis of clinical, radiological, and time-related factors and diverse outcomes.

RESULTS

In a cohort of 117 patients with a mean age of 58.5 years, 81 (69.2%) were male. Hypertension and diabetes mellitus were the most common risk factors, affecting 48.7% and 41% of the cohort, respectively. Approximately half of the patients had a favorable ASPECT Score (7-10), and 45.3% received intravenous tissue plasminogen activator (tPA). Nearly two-thirds achieved a modified thrombolysis in cerebral infarction (mTICI) score of 2b or higher, and 39.3% exhibited M1-middle cerebral artery (MCA) occlusion. The incidence of symptomatic hemorrhagic transformation was about 13%, whereas one-third of the patients attained a favorable mRs outcome (0-2). Factors such as advanced age, higher NIH Stroke Scale (NIHSS) scores, and prolonged hospital stays were associated with poorer outcomes. Conversely, the absence of hypertension and atrial fibrillation, along with higher TICI scores, significantly increased the likelihood of favorable outcomes, with P values of 0.015, 0.0490, and 0.025, respectively.

CONCLUSIONS

In our study, the examined patients who underwent EVT were younger in age, with clinical and radiological outcomes showing some degree of comparability to other publications. Notably, the absence of hypertension and atrial fibrillation, combined with a higher TICI score, was associated with an increased likelihood of achieving a favorable outcome.