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Background <p>Endovascular treatment (EVT) is among the first line therapies for symptomatic intracranial atherosclerotic stenosis (sICAS) patients, while post-EVT stroke hinders its efficacy. Thromboelastography (TEG), shows promise in predicting stroke events, yet research gaps exist regarding the role of TEG in post-EVT sICAS patients. This study adopts a retrospective case–control research method to explore the effectiveness of TEG in predicting stroke events after EVT.</p> Methods <p>Patients receiving EVT and a dual antiplatelet regimen for sICAS between September 1, 2020, and April 30, 2023, at Xuanwu Hospital, Capital Medical University, Beijing, were enrolled in this study. TEG parameters were measured 7&#xa0;days after dual antiplatelet regimen. Post-EVT strokes are defined as newly onset neurologic impairment and radiology changes after surgery. Multivariable logistic regression models were constructed to predict postoperative stroke occurrence.</p> Results <p>A total of 561 patients remained eligible for analysis, including 29 (5.2%) and 18 (3.2%) patients experienced ischemic strokes and hemorrhagic strokes after EVT. Multivariable analysis showed that ADP%, a TEG parameter, was an independent predictor for post-EVT ischemic events (OR = 0.642, 95% CI 0.425–0.971, <i>P</i> = 0.036). Logistic regression model that includes TEG parameters shows better predictive performance (ROC–AUC = 0.74) than the model including only baseline information (ROC–AUC = 0.70).</p> Conclusions <p>In people with sICAS, 25% decreased ADP% may be associated with higher post-EVT ischemic stroke risk. The integration of TEG parameters may enhance the accuracy of predicting post-EVT ischemic stroke.</p>

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Role of thromboelastography in predicting stroke risk after endovascular treatment for symptomatic intracranial atherosclerotic stenosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月11日

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  • Bo Zhou,
  • Haozhi Gong,
  • Jiazheng Li,
  • Jinjian Yang,
  • Bin Yang,
  • Peng Gao,
  • Yanfei Chen,
  • Yabing Wang,
  • Jian Chen,
  • Fei Chen,
  • Tao Wang,
  • Liqun Jiao

摘要

Background

Endovascular treatment (EVT) is among the first line therapies for symptomatic intracranial atherosclerotic stenosis (sICAS) patients, while post-EVT stroke hinders its efficacy. Thromboelastography (TEG), shows promise in predicting stroke events, yet research gaps exist regarding the role of TEG in post-EVT sICAS patients. This study adopts a retrospective case–control research method to explore the effectiveness of TEG in predicting stroke events after EVT.

Methods

Patients receiving EVT and a dual antiplatelet regimen for sICAS between September 1, 2020, and April 30, 2023, at Xuanwu Hospital, Capital Medical University, Beijing, were enrolled in this study. TEG parameters were measured 7 days after dual antiplatelet regimen. Post-EVT strokes are defined as newly onset neurologic impairment and radiology changes after surgery. Multivariable logistic regression models were constructed to predict postoperative stroke occurrence.

Results

A total of 561 patients remained eligible for analysis, including 29 (5.2%) and 18 (3.2%) patients experienced ischemic strokes and hemorrhagic strokes after EVT. Multivariable analysis showed that ADP%, a TEG parameter, was an independent predictor for post-EVT ischemic events (OR = 0.642, 95% CI 0.425–0.971, P = 0.036). Logistic regression model that includes TEG parameters shows better predictive performance (ROC–AUC = 0.74) than the model including only baseline information (ROC–AUC = 0.70).

Conclusions

In people with sICAS, 25% decreased ADP% may be associated with higher post-EVT ischemic stroke risk. The integration of TEG parameters may enhance the accuracy of predicting post-EVT ischemic stroke.