Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke: Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands

被引：12

作者：

Goldhoorn, R. B. ^{[1
]}

Mulder, Maxim J. H. L. ^{[2
]}

Jansen, Ivo G. H. ^{[3
]}

van Zwam, Wim H. ^{[4
]}

Staals, Julie ^{[1
]}

van der Lugt, Aad ^{[5
]}

Dippel, Diederik W. J. ^{[2
]}

Lingsma, Hester F. ^{[6
]}

Vos, Jan Albert ^{[7
]}

Boiten, Jelis ^{[8
]}

van den Wijngaard, Ido R. ^{[8
]}

Majoie, Charles B. L. M. ^{[3
]}

Roos, Yvo B. W. E. M. ^{[9
]}

van Oostenbrugge, Robert J. ^{[1
]}

Vos, Jan-Albert ^{[7
]}

Goldhoorn, Robert-Jan B. ^{[7
]}

Schonewille, Wouter J. ^{[10
]}

Coutinho, Jonathan M. ^{[9
]}

Wermer, Marieke J. H. ^{[13
]}

van Walderveen, Marianne A. A. ^{[4
,14
]}

Hofmeijer, Jeannette ^{[15
]}

Martens, Jasper M. ^{[16
]}

Nijeholt, Geert J. Lycklama A. ^{[17
]}

Roozenbeek, Bob ^{[2
]}

Emmer, Bart J. ^{[5
]}

de Bruijn, Sebastiaan F. ^{[19
]}

van Dijk, Lukas C. ^{[20
]}

van der Worp, H. Bart ^{[21
]}

Lo, Rob H. ^{[22
]}

van Dijk, Ewoud J. ^{[23
]}

Boogaarts, Hieronymus D. ^{[24
]}

de Kort, Paul L. M. ^{[26
]}

Peluso, Jo J. P. ^{[27
]}

van den Berg, Jan S. P. ^{[28
]}

van Hasselt, Boudewijn A. A. M. ^{[29
]}

Aerden, Leo A. M. ^{[30
]}

Dallinga, Rene J. ^{[31
]}

Uyttenboogaart, Maarten ^{[32
]}

Eshghi, Omid ^{[33
]}

Schreuder, Tobien H. C. M. L. ^{[34
]}

Heijboer, Roel J. J. ^{[35
]}

Keizer, Koos ^{[36
]}

Yo, Lonneke S. F. ^{[37
]}

den Hertog, Heleen M. ^{[38
]}

Sturm, Emiel J. C. ^{[39
]}

Sprengers, Marieke E. S. ^{[10
]}

Jenniskens, Sjoerd F. M. ^{[25
]}

van den Berg, Rene ^{[10
]}

Yoo, Albert J. ^{[41
]}

Beenen, Ludo F. M. ^{[10
]}

机构：

[1] Maastricht Univ, Med Ctr, Dept Neurol, Room 4-R1-032,P Debyelaan 25, NL-6229 HX Maastricht, Limburg, Netherlands

[2] Erasmus MC Univ, Med Ctr, Dept Neurol, Rotterdam, South Holland, Netherlands

[3] Acad Med Ctr, Dept Radiol & Nucl Med, Amsterdam, North Holland, Netherlands

[4] Maastricht Univ, Med Ctr, Dept Radiol, Maastricht, Limburg, Netherlands

[5] Erasmus MC Univ, Med Ctr, Dept Radiol, Rotterdam, South Holland, Netherlands

[6] Erasmus MC Univ, Med Ctr, Dept Publ Hlth, Rotterdam, South Holland, Netherlands

[7] St Antonius Hosp, Dept Radiol, Utrecht, Netherlands

[8] Haaglanden Med Ctr, Dept Neurol, The Hague, South Holland, Netherlands

[9] Acad Med Ctr, Dept Neurol, Amsterdam, Netherlands

[10] Acad Med Ctr, Dept Radiol, Amsterdam, Netherlands

[11] Acad Med Ctr, Dept Biomed Engn & Phys, Amsterdam, Netherlands

[12] St Antonius Hosp, Dept Neurol, Nieuwegein, Netherlands

[13] Leiden Univ, Med Ctr, Dept Neurol, Leiden, Netherlands

[14] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands

[15] Rijnstate Hosp, Dept Neurol, Arnhem, Netherlands

[16] Rijnstate Hosp, Dept Radiol, Arnhem, Netherlands

[17] MC Haaglanden, Dept Radiol, The Hague, Netherlands

[18] MC Haaglanden, Dept Neurol, The Hague, Netherlands

[19] HAGA Hosp, Dept Neurol, The Hague, Netherlands

[20] HAGA Hosp, Dept Radiol, The Hague, Netherlands

[21] Univ Med Ctr Utrecht, Dept Neurol, Utrecht, Netherlands

[22] Univ Med Ctr Utrecht, Dept Radiol, Utrecht, Netherlands

[23] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Nijmegen, Netherlands

[24] Radboud Univ Nijmegen, Med Ctr, Dept Neurosurg, Nijmegen, Netherlands

[25] Radboud Univ Nijmegen, Med Ctr, Dept Radiol, Nijmegen, Netherlands

[26] Sint Elisabeth Hosp, Dept Neurol, Tilburg, Netherlands

[27] Sint Elisabeth Hosp, Dept Radiol, Tilburg, Netherlands

[28] Isala Klin, Dept Neurol, Zwolle, Netherlands

[29] Isala Klin, Dept Radiol, Zwolle, Netherlands

[30] Reinier Graaf Gasthuis, Dept Neurol, Delft, Netherlands

[31] Reinier Graaf Gasthuis, Dept Radiol, Delft, Netherlands

[32] Univ Med Ctr Groningen, Dept Neurol, Groningen, Netherlands

[33] Univ Med Ctr Groningen, Dept Radiol, Groningen, Netherlands

[34] Atrium Med Ctr, Dept Neurol, Heerlen, Netherlands

[35] Atrium Med Ctr, Dept Radiol, Heerlen, Netherlands

[36] Catharina Hosp, Dept Neurol, Eindhoven, Netherlands

[37] Catharina Hosp, Dept Radiol, Eindhoven, Netherlands

[38] Med Spectrum Twente, Dept Neurol, Enschede, Netherlands

[39] Med Spectrum Twente, Dept Radiol, Enschede, Netherlands

[40] Vrije Univ Amsterdam Med Ctr, Dept Radiol, Amsterdam, Netherlands

[41] Texas Stroke Inst, Dept Radiol, Plano, TX USA

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2019年 / 28卷 / 03期

关键词：

Ischemic stroke; endovascular treatment; minor symptoms; large vessel oclusion; LARGE VESSEL OCCLUSION; MECHANICAL THROMBECTOMY; INTRAARTERIAL TREATMENT; ANTERIOR CIRCULATION; NIHSS SCORE; SCALE SCORE; THERAPY; MILD; ANGIOGRAPHY; TRIAL;

D O I：

10.1016/j.jstrokecerebrovasdis.2018.10.029

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score <= 5 (NIHSS score <= 5) and moderate to severe ischemic stroke (NIHSS score >= 6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT. Materials and Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Minor ischemic stroke was defined as baseline NIHSS score of 5 or less. Primary outcome is the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes include symptomatic intracranial hemorrhage (sICH) and mortality. Findings: Seventy-one (5.5%) patients had a NIHSS score of 5 or less. Functional independence (mRS 0-2 at 90 days) was reached in 75% of these patients, compared to 40% of patients with NIHSS score of 6 or more. sICH occurred in 4% of patients, of which 1% occurred peri-interventionally. Death occurred in 6% of patients. Conclusions: Patients with minor ischemic stroke with an intracranial proximal arterial occlusion of the anterior circulation who underwent EVT have a high chance of favorable outcome and appear to have low occurrence of treatment-related sICH. Therefore, our results encourage the use of EVT for minor ischemic stroke in the absence of effect estimates from controlled studies.

引用

页码：542 / 549

页数：8

共 28 条

[1] Baseline NIH Stroke Scale score strongly predicts outcome after stroke - A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) [J].

Adams, HP ;

Davis, PH ;

Leira, EC ;

Chang, KC ;

Bendixen, BH ;

Clarke, WR ;

Woolson, RF ;

Hansen, MD .

NEUROLOGY, 1999, 53 (01) :126-131

[2]

[Anonymous], 2017, J NEUROINTERV SURG

[3] Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy [J].

Barber, PA ;

Demchuk, AM ;

Zhang, JJ ;

Buchan, AM .

LANCET, 2000, 355 (9216) :1670-1674

[4] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[5] Collateral Status on Baseline Computed Tomographic Angiography and Intra-Arterial Treatment Effect in Patients With Proximal Anterior Circulation Stroke [J].

Berkhemer, Olvert A. ;

Jansen, Ivo G. H. ;

Beumer, Debbie ;

Fransen, Puck S. S. ;

van den Berg, Lucie A. ;

Yoo, Albert J. ;

Lingsma, Hester F. ;

Sprengers, Marieke E. S. ;

Jenniskens, Sjoerd F. M. ;

Lycklama a Nijeholt, Geert J. ;

van Walderveen, Marianne A. A. ;

van den Berg, Rene ;

Bot, Joseph C. J. ;

Beenen, Ludo F. M. ;

Boers, Anna M. M. ;

Slump, Cornelis H. ;

Roos, Yvo B. W. E. M. ;

van Oostenbrugge, Robert J. ;

Dippel, Diederik W. J. ;

van der Lugt, Aad ;

van Zwam, Wim H. ;

Marquering, Henk A. ;

Majoie, Charles B. L. M. .

STROKE, 2016, 47 (03) :768-776

[6] Mechanical thrombectomy in patients with M1 occlusion and NIHSS score ≤5: a single-centre experience [J].

Bhogal, P. ;

Buecke, P. ;

Ganslandt, O. ;

Baezner, H. ;

Henkes, H. ;

Perez, M. Aguilar .

STROKE AND VASCULAR NEUROLOGY, 2016, 1 (04) :165-171

[7] MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - A CLINICAL EXAMINATION SCALE [J].

BROTT, T ;

ADAMS, HP ;

OLINGER, CP ;

MARLER, JR ;

BARSAN, WG ;

BILLER, J ;

SPILKER, J ;

HOLLERAN, R ;

EBERLE, R ;

HERTZBERG, V ;

RORICK, M ;

MOOMAW, CJ ;

WALKER, M .

STROKE, 1989, 20 (07) :864-870

[8] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J].

Campbell, B. C. V. ;

Mitchell, P. J. ;

Kleinig, T. J. ;

Dewey, H. M. ;

Churilov, L. ;

Yassi, N. ;

Yan, B. ;

Dowling, R. J. ;

Parsons, M. W. ;

Oxley, T. J. ;

Wu, T. Y. ;

Brooks, M. ;

Simpson, M. A. ;

Miteff, F. ;

Levi, C. R. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Priglinger, M. ;

Ang, T. ;

Scroop, R. ;

Barber, P. A. ;

McGuinness, B. ;

Wijeratne, T. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Bladin, C. F. ;

Badve, M. ;

Rice, H. ;

de Villiers, L. ;

Ma, H. ;

Desmond, P. M. ;

Donnan, G. A. ;

Davis, S. M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1009-1018

[9] Mechanical Thrombectomy for Isolated M2 Occlusions: A Post Hoc Analysis of the STAR, SWIFT, and SWIFT PRIME Studies [J].

Coutinho, J. M. ;

Liebeskind, D. S. ;

Slater, L. -A. ;

Nogueira, R. G. ;

Baxter, B. W. ;

Levy, E. I. ;

Siddiqui, A. H. ;

Goyal, M. ;

Zaidat, O. O. ;

Davalos, A. ;

Bonafe, A. ;

Jahan, R. ;

Gralla, J. ;

Saver, J. L. ;

Pereira, V. M. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2016, 37 (04) :667-672

[10] Mechanical Thrombectomy for Minor and Mild Stroke Patients Harboring Large Vessel Occlusion in the Anterior Circulation A Multicenter Cohort Study [J].

Dargazanli, Cyril ;

Arquizan, Caroline ;

Gory, Benjamin ;

Consoli, Arturo ;

Labreuche, Julien ;

Redjem, Hocine ;

Eker, Omer ;

Decroix, Jean-Pierre ;

Corlobe, Astrid ;

Mourand, Isabelle ;

Gaillard, Nicolas ;

Ayrignac, Xavier ;

Charif, Mahmoud ;

Duhamel, Alain ;

Labeyrie, Paul-Emile ;

Riquelme, Carlos ;

Ciccio, Gabriele ;

Smajda, Stanislas ;

Desilles, Jean-Philippe ;

Gascou, Gregory ;

Lefevre, Pierre-Henri ;

Mantilla-Garcia, Daniel ;

Cagnazzo, Federico ;

Coskun, Oguzhan ;

Mazighi, Mikael ;

Riva, Roberto ;

Bourdain, Frederic ;

Labauge, Pierre ;

Rodesch, Georges ;

Obadia, Michael ;

Bonafe, Alain ;

Turjman, Francis ;

Costalat, Vincent ;

Piotin, Michel ;

Blanc, Raphael ;

Lapergue, Bertrand .

STROKE, 2017, 48 (12) :3274-3281

← 1 2 3 →