KẾT QUẢ LẤY HUYẾT KHỐI BỆNH NHÂN NHỒI MÁU NÃO CẤP DO TẮC ĐỘNG MẠCH LỚN TUẦN HOÀN NÃO TRƯỚC CỬA SỔ 6 ĐẾN 24 GIỜ ĐƯỢC CHẨN ĐOÁN BẰNG CẮT LỚP VI TÍNH

Abstract

Objects: Acute ischemic stroke due to anterior circulation large vessel occlusion (LVO) is a severe condition with poor outcomes if not promptly reperfused. In settings without advanced imaging, basic CT scan can be a practical tool for selecting patients for thrombectomy in the extended time window (6–24 hours). This study evaluates the effectiveness of mechanical thrombectomy in such patients. Methods: A cross-sectional study was conducted on 66 medical records with acute anterior circulation LVO stroke who underwent mechanical thrombectomy at Bach Mai Hospital between 6 - 12/2024. Results: The mean age was 67.4 ± 10.6 years, with most patients living in rural areas. The most common occlusion sites were the middle cerebral artery (MCA), either alone (37.9%) or combined (31.8%) with internal carotid artery (ICA). Good recanalization (mTICI ≥ 2b) was achieved in 84.8% of cases, with 53% reaching mTICI 3. After 3 months, 18.2% showed significant clinical improvement (mRS 0 - 2). MCA occlusion was 6.27 times more likely to have good recanalization compared to intracranial ICA occlusion. Longer onset-to-treatment time was linked to lower recanalization success. Patients aged ≥60 had worse functional outcomes at 3 months. Conclusion: Mechanical thrombectomy guided by basic CT in the extended time window remains effective for recanalization and clinical recovery. These findings support expanding intervention access in primary care settings without advanced imaging capabilities.