Abstract
Objective: To describe the outcomes of mechanical thrombectomy in patients with acute ischemic stroke due to anterior circulation large vessel occlusion within the 6–24-hour time window at Nghe An Friendship General Hospital. Methods: This prospective descriptive study included 47 patients aged ≥18 years with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent mechanical thrombectomy within the 6–24-hour time window from symptom onset or last known well. Patients were selected based on NIHSS ≥6, ASPECTS ≥6, pre-stroke mRS 0–2, and ICA or MCA M1 occlusion confirmed on CTA. The primary outcomes were successful reperfusion, defined as mTICI 2b–3, and functional independence at 90 days, assessed through in-person follow-up or a standardized telephone interview. Secondary outcomes included any intracranial hemorrhage, symptomatic intracranial hemorrhage according to ECASS III criteria, and 90-day mortality. Results: The mean age was 66.59 ± 12.49 years, and patients aged ≥60 years accounted for 78.72%. Female patients accounted for 55.3%, and male patients for 44.7%. The most frequently used thrombectomy technique was stent retriever thrombectomy, accounting for 53.2%; most patients required one or two thrombectomy passes, accounting for 76.6%. The median onset/last-known-well-to-door time was 7.28 hours (IQR: 6.62–9.18), and the median door-to-puncture time was 60 minutes (IQR: 48–87). Successful reperfusion, defined as mTICI 2b–3, was achieved in 80.9% of patients; complete reperfusion, mTICI 3, was achieved in 19.2%. Any intracranial hemorrhage occurred in 31.9% of patients, whereas symptomatic intracranial hemorrhage occurred in 6.4%. At 90 days, 36.2% of patients achieved functional independence, defined as mRS 0–2, while 63.8% had mRS 3–6. Conclusion: Mechanical thrombectomy within the 6–24-hour time window in the study population awas associated with a successful reperfusion rate of 80.9%, a symptomatic intracranial hemorrhage rate of 6.4%, and a 90-day functional independence rate of 36.2%. These preliminary findings suggest the feasibility of a patient selection strategy based on non-contrast CT combined with CTA in routine practice at a provincial stroke center.
