Aspiration pneumonia represents a significant complication following mechanical thrombectomy for acute ischemic stroke, with incidence rates of 12-30%. This study evaluated the clinical efficacy of integrating early risk identification with bronchoscopic intervention for preventing and managing post-thrombectomy aspiration pneumonia. A retrospective cohort study was conducted at Cangzhou Central Hospital from January 2021 to December 2023, enrolling 150 patients who underwent mechanical thrombectomy. Patients were allocated to conventional treatment (n=71) or bronchoscopic intervention (n=79) groups. The bronchoscopy group received flexible bronchoscopic procedures (median 36 hours post-thrombectomy) including bronchoalveolar lavage and targeted therapy, in addition to standard care. Primary outcome was aspiration pneumonia incidence at day 14. Secondary outcomes included clinical effectiveness parameters, inflammatory biomarkers, and functional outcomes. The bronchoscopy group demonstrated significantly lower aspiration pneumonia incidence (10.1% vs 29.6%, P=0.005), superior treatment response rate (88.0% vs 65.0%, P<0.05), and higher clinical cure rate (75.0% vs 50.0%, P<0.05). Hospital stay was reduced (13.0±3.5 vs 16.5±4.0 days, P<0.001), and symptom improvement time shortened (6.5±2.0 vs 9.2±2.5 days, P<0.001). Inflammatory markers (WBC, CRP, PCT, IL-6) were significantly lower in the intervention group (all P<0.05). Functional outcomes including mRS, NIHSS, Barthel Index, and swallowing function showed marked improvement. Bacterial identification rate improved to 92.4% vs 71.8% (P<0.05), enabling targeted antimicrobial therapy. The intervention demonstrated a favorable safety profile with procedure-related complications in 13.9% of patients, all resolving completely. Integration of early bronchoscopic intervention with conventional treatment significantly reduces aspiration pneumonia incidence, accelerates clinical recovery, attenuates systemic inflammation, and improves functional outcomes in post-thrombectomy patients, with an acceptable safety profile.
Wang et al. (Sun,) studied this question.