To study the relationship between the first CT signs after mechanical thrombectomy and prognosis of patients based on different neutrophil-lymphocyte ratios (NLR).

The clinical data of 201 patients who underwent mechanical thrombectomy from January 2017 to December 2021 in the Neurology Department of The First People's Hospital of Zhangjiagang City were retrospectively analyzed. According to the first postoperative CT imaging, they were divided into high-density CT imaging group and non high-density CT imaging group; At the same time, they were divided into low NLR group and high NLR group according to preoperative NLR values, and then subgroup analysis was conducted based on whether there were high-density shadows on the first postoperative CT. The 90-day good prognosis rate, the incidence of symptomatic intracranial hemorrhage and the mortality rate within 90 d were compared among the subgroups.

There were 100 patients with high-density CT imaging after operation (high-density CT imaging group), and the remaining 101 patients were included in the non high-density CT imaging group. The rate of symptomatic intracranial hemorrhage in the non high-density CT imaging group was lower than that in high-density CT imaging group (OR=0.207, 95%CI: 0.082-0.521, P<0.001), but there was no statistically significant difference in 90-day good prognosis and mortality between the two groups (P>0.05). There were 137 patients in the low NLR group. There was no significant difference in the rate of 90-day good prognosis, mortality and symptomatic intracranial hemorrhage at 90 d between the subgroup without and with high-density CT imaging (P>0.05). There were 64 patients in the high NLR group. Compared with the subgroup with high-density CT imaging, the subgroup without high-density CT imaging had a higher 90-day good prognosis (OR=3.515, 95%CI: 1.051-11.748, P=0.041), and a lower 90-day mortality (OR=0.262, 95%CI: 0.071-0.977, P=0.046), symptomatic intracranial hemorrhage rate was low (OR=0.132, 95%CI: 0.026-0.679, P=0.015).

After mechanical thrombectomy, CT with high-density imaging has a higher rate of symptomatic intracranial hemorrhage than without high-density imaging, but it has no significant effect on prognosis. In patients with high NLR, the first high-density CT imaging after thrombectomy affects the clinical prognosis; In patients with low NLR, the presence or absence of high-density has no significant effect on prognosis.