| Abstract [eng] |
Mechanical thrombectomy for acute ischemic stroke caused by large artery occlusion is a highly effective procedure to reduce disability in selected patients. However, the clinical outcome depends on the technical success of the procedure. The best patient outcomes are observed after complete recanalisation, which should be achieved after the first pass. The aim of this study was to develop a prognostic algorithm for mechanical thrombectomy of cerebral arteries based on radiological assessment of cerebral artery and clot characteristics, allowing pre-procedural prediction of difficult thrombectomy with standard tools. The results of the study showed that: 1. the morphological "chicken-wing" type of the left atrial appendage is associated with a higher proportion of erythrocyte-rich thrombus than other morphological types; 2. the tortuosity of the internal carotid artery and the middle cerebral artery, and the relative density of the thrombus, are associated with the technical success of mechanical thrombectomy; 3. a prognostic algorithm was developed to predict difficult mechanical thrombectomy with 78.7% accuracy using a balloon occlusion catheter and a second-generation stent retriever. |
