The Claw Sign : An angiographic Predictor of Recanalization After Mechanical Thrombectomy for Cerebral Large Vessel Occlusion

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書誌事項

タイトル
The Claw Sign : An angiographic Predictor of Recanalization After Mechanical Thrombectomy for Cerebral Large Vessel Occlusion
タイトル別名
  • かに爪様徴候 : 脳主幹動脈閉塞に対する血栓回収療法後の血管造影上の再開通予測因子
  • AN ANGIOGRAPHICAL PREDICTOR FOR SUCCESSFUL RECANALIZATION
著者
山本, 雄貴
著者別名
  • ヤマモト, ユウキ
  • Yamamoto, Yuki
著者
山本, 伸昭
著者別名
  • ヤマモト, ノブアキ
  • Yamamoto, Nobuaki
著者
兼松, 康久
著者別名
  • カネマツ, ヤスヒサ
  • Kanematsu, Yasuhisa
著者
高麗, 雅章
著者別名
  • コウライ, マサアキ
  • Korai, Masaaki
著者
島田, 健司
著者別名
  • シマダ, ケンジ
  • Shimada, Kenji
著者
和泉, 唯信
著者別名
  • イズミ, ユイシン
  • Izumi, Yuishin
著者
高木, 康志
著者別名
  • タカギ, ヤスシ
  • Takagi, Yasushi
学位授与大学
徳島大学
取得学位
博士（医学）
学位授与番号
甲医第1450号
学位授与年月日
2020-03-18

説明

Background: Mechanical thrombectomy undoubtedly improves functional outcomes for patients with acute ischemic stroke. Although we have observed occlusion sites that protrude proximally into the vessel on angiography, termed the “claw sign,” we have been unable to state its clinical significance. In this study, we aimed to determine whether the presence of a claw sign was related to recanalization success after mechanical thrombectomy. Materials and Methods: We retrospectively included 73 consecutive patients treated for acute cerebral large vessel occlusion by mechanical thrombectomy between January 2014 and December 2017. The angiographic claw sign was defined as a thrombus that protruded proximally by more than half the diameter of the parent artery. Claw sign positivity, clinical and etiological features, and outcomes were compared between groups with and without recanalization. Results: The claw sign was observed in 29 of 73 (40%) patients and was positive significantly more frequently in those with recanalization (50.0%) than in those without recanalization (5.9%) (P < .01). By multivariate analysis, the claw sign was the only pretreatment parameter to predict successful recanalization (odds ratio, 12.50; 95% confidence interval, 1.50-103.00; P = .019). Conclusions: The presence of the claw sign might predict successful recanalization in patients undergoing mechanical thrombectomy for large vessel occlusion.

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