Introduction/Purpose Mechanical aspiration (MA) has revolutionized the management of acute ischemic stroke caused by large vessel occlusion. We aimed to analyze the early outcomes and technical nuances of MA procedures performed at our center, focusing on success rates, procedure duration, and complications. Materials/Methods We retrospectively reviewed 32 consecutive cases of acute ischemic stroke treated with mechanical aspiration. Demographics, NIHSS/mRS at admission and discharge, occluded vessel, technique, devices used, and procedural time were recorded. Successful recanalization was defined as TICI 2b‐3. Descriptive analysis was performed to assess outcomes. Results Among 32 patients (age range 36‐87 years), comorbidities were highly prevalent. The majority had arterial hypertension (grade III, risk 4) with evidence of target organ damage involving the heart, brain, and retinal vessels. Many patients also had ischemic heart disease (IHD), frequently with ischemic cardiomyopathy and heart failure (NYHA functional classes I‐III). Atrial fibrillation (both persistent and permanent forms) was a common arrhythmia, often coexisting with hypertension and IHD. Several patients had a history of previous cardiac interventions, including coronary artery stenting, aortic valve replacement, mitral valve replacement, and coronary artery bypass grafting (CABG).The most frequently affected vascular territories were the M1 and M2 segments of the middle cerebral artery (MCA), followed by the vertebrobasilar system (VBA) and posterior cerebral artery (PCA) segments (P1‐P2), with occasional involvement of the anterior cerebral artery (ACA). Mechanical thrombectomy (MT) was the predominant treatment modality, often combined with thrombolytic therapy or endovascular aspiration, particularly in posterior circulation strokes. Complete recanalization (TICI 3) was achieved in multiple MCA and PCA cases, while failed or limited recanalization (TICI 0‐1) was noted in some posterior circulation occlusions. Despite the high success rate of recanalization, complications such as hemiplegia, aphasia, and bulbar dysfunction remained common. These findings underscore the complexity of managing large vessel occlusions, especially in the posterior circulation, where outcomes were generally less favorable. The majority of patients demonstrated neurological improvement by discharge, with mRS ≤2 in several cases.Patients demonstrated a substantial improvement in both NIHSS and mRS scores from admission to discharge. Half of the cohort achieved a favorable functional outcome (mRS ≤2), indicating the effectiveness of mechanical aspiration in this low‐resource setting despite the high initial neurological deficits Conclusion This single‐center analysis demonstrates encouraging recanalization rates and procedure times, underscoring the feasibility of MA in a low‐resource setting. Optimized device selection and early identification of occlusion patterns remain essential for maximizing patient outcomes.
Y. Merkibekov (Sat,) studied this question.