Good recanalization is associated with long term favorable outcomes in acute stroke patients with large vessel occlusion treated with endovascular therapy

被引:1
作者
Arakawa, Masafumi [1 ]
Suzuki, Kentaro [1 ]
Kutsuna, Akihito [1 ]
Katano, Takehiro [1 ]
Kanamaru, Takuya [1 ]
Aoki, Junya [1 ]
Sakamoto, Yuki [1 ]
Suda, Satoshi [1 ]
Kimura, Kazumi [1 ]
机构
[1] Nippon Med Sch, Grad Sch Med, Dept Neurol Sci, Tokyo, Japan
关键词
Acute ischemic stroke; Large vessel occlusion; Endovascular therapy; Long-term outcome; ACUTE ISCHEMIC-STROKE; THROMBECTOMY; REPERFUSION; ETIOLOGY; PA;
D O I
10.1016/j.jns.2020.117009
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The long-term outcome in acute stroke patients with large vessel occlusion (LVO) treated with endovascular therapy (EVT) are unclear. We investigated functional outcomes one year after EVT in acute stroke patients with LVO. Methods: We retrospectively enrolled 149 stroke patients with LVO who underwent EVT from our prospective stroke registry. We assessed modified Rankin Scale (mRS) scores at one year from onset. The degree of recanalization was evaluated using modified thrombolysis in cerebral infarction (mTICI) grades. Good recanalization and a favorable outcome were defined as an mTICI grade >= 2b and mRS score <= 2, respectively. Results: Favorable outcomes were observed in 76 (51.0%) patients. The favorable outcome group was younger (median age: 72 [interquartile range, 63-79] years vs. 79 [70-84] years, P <.001) and had more male patients (79% vs. 60%, P =.013), lower National Institutes of Health Stroke Scale scores at admission (median 14 [7-18]) vs. 19 [15-25], P <.001), higher DWI-ASPECTS upon admission (median [6-9] vs. 6 [4-8], P=.022), more patients with mTICI >= 2b (93% vs. 64%, P <.001) and fewer post-therapy intracranial cerebral hemorrhages (13% vs. 29%, P =.019) than the poor outcome group. In our multivariate analysis, mTICI >= 2b were independently associated with favorable outcomes at one year from onset (odds ratio, 10.282; 95% confidence interval, 1.587-66.604; P =.015). Conclusions: Good recanalization was associated with favorable functional outcomes one year after EVT in acute stroke patients with LVO.
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页数:7
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