Kết quả điều trị nhồi máu não cấp do tắc mạch máu lớn đến muộn bằng can thiệp nội mạch kết hợp trí tuệ nhân tạo (RAPID) tại Bệnh viện Đa khoa tỉnh Phú Thọ

Evaluation of the results of treatment for late coming patients with acute cerebral infarction due to large vessel occlusion by endovascular intervention combined with artificial intelligence software (Rapid). Objects and methods: Methods included clinical intervention, self-control, and comparison of results before and after treatment. Patients were monitored for neurological function in 90 days after the intervention. The study was carried out on 69 patients with acute cerebral infarction caused by large cerebral artery occlusion (internal carotid artery and middle cerebral artery) hospitalized after 6 hours of cerebral perfusion imaging (CT Perfusion, MRI Perfusion) treated in combination with artificial intelligence software (RAPID) to remove intravascular thrombus during the period from January 2020 to March 2022 at Phu Tho Provincial General Hospital. Results: The proportion of males in the study group was 1.2 times as much as that of females. Mean age was 64 (51-87). The average NIHSS score was 16, the rate of occlusion of the internal carotid artery accounted for 31.9%, the rate of occlusion of the middle cerebral artery was 68.1%. The mean infarct core volume was 13.2 ml (0-41ml). Mismatch area volume was 67ml (21-148ml). Good results of revascularization intervention (TICI 2b-3) accounted for 73.9%, the rate of failure (TICI 0) was 7.2%. The rate of good clinical recovery (mRS 0-2) after 90 days accounted was 45.7%, mortality accounted for 4.3%. The rate of symptomatic intracranial bleeding was 8.7%. Conclusion: The combination between artificial intelligence (Rapid) with endovascular thrombectomy was safe and brought good results for recovery in neurological function (45,7%) for late coming patients with acute cerebral infarction due to large vessel occlusion (6-24 hours).