Efficacy and safety of endovascular thrombectomy in mild ischemic stroke: results from a retrospective study and meta-analysis of previous trials.

BACKGROUND: Mechanical thrombectomy has been proven as a standard care for moderate to severe ischemic stroke with anterior large vessel occlusion (LVO); however, whether it is equally effective in mild ischemic stroke (MIS) is controversial. METHODS: In this retrospective study, a total of 177 Chinese patients presenting with MIS (NIHSS ≤8) and LVO between January 2014 and September 2017 from seven comprehensive stroke centers were identified. Odds of good outcome with endovascular thrombectomy versus medical treatment were obtained by logistic regression analysis and propensity-score matching method, and a meta-analysis pooled results from six studies (n = 733). RESULTS: Good outcome (mRS: 0-1) was 58.2% (46/79) in the thrombectomy and 46.9% (46/98) in the medical group, which showed no statistical significance before adjustment (P = 0.13; OR = 1.57, 95% CI: 0.86 to 2.86). The adjusted ORs of thrombectomy versus medical group were 3.23 (95% CI, 1.35 to 7.73; P = 0.008) by multivariable logistic analysis, 2.78 (1.12 to 6.89; P = 0.02) by propensity score matching analysis, and 3.20 (1.22 to 8.37; P = 0.01) by propensity score matching analysis with additional adjustments, respectively. Thrombectomy treatment did not result in excessive mortality or symptomatic intracranial hemorrhage after adjustments. The meta-analysis did not confirm the associations between good outcome and endovascular treatment. CONCLUSIONS: The current study indicates that endovascular thrombectomy is associated with good functional outcome in MIS patients with LVO, and without additional risk of symptomatic intracranial hemorrhage and mortality. Although the meta-analysis failed to demonstrate its superiority compared to medical treatment, randomized clinical trials are needed.

[Effect of sand dust weather on major water-soluble ions in PM10 in Lanzhou, China].

The major water-soluble ions (Ca(2+), NH(4+), Mg(2+), K(+), Na(+), SO4(2-), NO3(-) and Cl-(-) in PM10 at 1-h interval were measured by an online analyzer for monitoring of Aerosols and Gases (MARGA) at the campus of Lanzhou University, from April 1 to June 30, 2011. There were 15 days of dust weather during the monitoring period. The main water-soluble ions in PM10 were Ca(2+), SO4(2-) and NO3(-). The concentration of NO3(-) and NH4(+) decreased during blowing sand weather comparing with non-dust, this phenomenon showed that the dust weather had the function of eliminating the local anthropogenic emissions. As the soil pollution marker, the concentration of Mg(2+), Na(+) and Ca(2+) increased during dust weather comparing with non-dust. The correlation coefficients between Na(+) and Mg(2+), Na(+) and Ca(2+), Mg(2+) and Ca(2+) during dust weather were 0.520, 0.659 and 0.671, respectively. The similar correlation coefficients indicated that some fraction of these species was derived from the same sources, such as soil dust. The correlation coefficients between Na(+) and Mg(2+), Na(+) and Ca(2+), Mg(2+) and Ca(2+) during non-dust weather were not strong, only 0.065, 0.131 and 0.163, respectively. The low correlation coefficients indicated that these species were derived from different sources. The mass concentration of Cl(-) in the dust weather was significantly higher than that of floating dust and non dust, indicating that soil dust was the main source of Cl(-).