Effect of inflammatory response before mechanical thrombectomy on prognosis in stroke patients

Ideggyogy Sz. 2024 Sep 30;77(9-10):323-327. doi: 10.18071/isz.77.0323.

Abstract

Background and purpose: <p>Mechanical thrombectomy is the most important treatment modality in acute stroke; despite successful thrombectomy, good functional outcome is not achieved in a significant proportion of patients. This study examined the effect of neutrophil lymphocyte ratio (NLR) values at admission on functional outcomes in successfully recanalized patients.</p>.

Methods: <p>Patients who underwent mechanical thrombectomy due to anterior system major vessel occlusion were retrospectively analyzed and compared with the admission NLR values and 3-month clinical modified Rankin Scale (mRS) scores of successfully recanalized patients.</p>.

Results: <p>Of a total of 126 patients who underwent thrombectomy within the specified period, 97 patients with successful recanalization were included in the study. The overall successful recanalization rate was calculated as 77%. The mean NLR of patients with mRS &le;2 (n=65) was found to be significantly lower than patients with mRS&ge;3 (n=32) (p&lt;0.001). A weak and significant correlation was found between National Institutes of Health Stroke Scale (NIHSS) value and NLR (r= 0.315, p=.002).</p>.

Conclusion: <p>NLR value has been found to be associated with futile recanalization in me&shy;chanical thrombectomy patients. There&shy;fore, we think that suppression of inflammation before thrombectomy will increase the chan&shy;ce of successful thrombectomy.</p>.

Background and purpose: <p>A mechanikus throm&shy;bec&shy;to&shy;mia az akut stroke legfontosabb kezel&eacute;si m&oacute;dja; a sikeres thrombectomia ellen&eacute;re a betegek je&shy;lentős r&eacute;sz&eacute;n&eacute;l nem &eacute;rhető el j&oacute; funkcion&aacute;lis eredm&eacute;ny. Ez a tanulm&aacute;ny a neutrophil-lym&shy;pho&shy;cyta ar&aacute;ny (neutrophil lymphocyte ratio, NLR) k&oacute;rh&aacute;zi felv&eacute;telkor m&eacute;rt &eacute;rt&eacute;keinek hat&aacute;s&aacute;t vizsg&aacute;lta a sikeresen rekanaliz&aacute;lt betegek funkcion&aacute;lis kimenetel&eacute;re.</p>.

Methods: <p>Visszamenőlegesen elemezt&uuml;k azokat a betegeket, akikn&eacute;l mechanikus thrombectomi&aacute;t v&eacute;geztek el&uuml;lső rendszerbeli nagy&eacute;relz&aacute;r&oacute;d&aacute;s miatt, &eacute;s &ouml;sszehasonlított&aacute;k a sikeresen rekanaliz&aacute;lt betegek felv&eacute;teli NLR-&eacute;rt&eacute;keivel &eacute;s a h&aacute;rom h&oacute;napos klinikai m&oacute;dosított Rankin-sk&aacute;la (mRS) pontsz&aacute;maival.</p>.

Results: <p>Az &ouml;sszesen 126 beteg k&ouml;z&uuml;l, akikn&eacute;l a megadott időszakon bel&uuml;l thrombectomi&aacute;t v&eacute;geztek, 97 sikeres rekanaliz&aacute;ci&oacute;val rendelkező beteget vontunk be a vizsg&aacute;latba. A teljes sikeres rekanaliz&aacute;ci&oacute;s ar&aacute;ny 77% volt. Az mRS &le;2 (n = 65) betegek &aacute;tlagos NLR-&eacute;rt&eacute;ke szignifik&aacute;nsan alacsonyabbnak bizonyult, mint az mRS &ge;3 (n = 32) betegek&eacute; (p &lt; 0,001). Gyenge &eacute;s szignifik&aacute;ns korrel&aacute;ci&oacute;t tal&aacute;ltunk a National Institutes of Health Stroke Scale (NIHSS) &eacute;rt&eacute;ke &eacute;s az NLR k&ouml;z&ouml;tt (r = 0,315, p = 0,002).</p>.

Conclusion: <p>Az NLR-&eacute;rt&eacute;k &ouml;sszef&uuml;gg&eacute;st mutat a mechanikus thrombectomi&aacute;val kezelt betegek sikertelen rekanaliz&aacute;ci&oacute;j&aacute;val. Ez&eacute;rt &uacute;gy gondoljuk, hogy a gyullad&aacute;s thrombectomia előtti szuppresszi&oacute;ja n&ouml;veli a sikeres thrombectomia es&eacute;ly&eacute;t.</p>.

Keywords: inflammation; mechanical thrombec­tomy; neutrophil to lympho­cyte ratio; prognosis; stroke.

MeSH terms

  • Aged
  • Female
  • Humans
  • Inflammation
  • Lymphocytes*
  • Male
  • Middle Aged
  • Neutrophils*
  • Prognosis
  • Retrospective Studies
  • Stroke* / surgery
  • Thrombectomy*
  • Treatment Outcome