Effect of Endovascular Therapy on Subsequent Decompressive Hemicraniectomy in Cardioembolic Ischemic Stroke with Proximal Intracranial Occlusion in the Anterior Circulation: Sub-Analysis of the RESCUE-Japan Registry 2

被引：7

作者：

Matsukawa, Hidetoshi ^{[1
]}

Kiura, Yoshihiro ^{[2
]}

Sakai, Nobuyuki ^{[3
]}

Yamagami, Hiroshi ^{[4
,5
]}

Uchida, Kazutaka ^{[1
,6
]}

Morimoto, Takeshi ^{[6
]}

Kageyama, Hiroto ^{[1
]}

Yoshimura, Shinichi ^{[1
]}

机构：

[1] Hyogo Coll Med, Dept Neurosurg, 1-1 Mukogawa, Nishinomiya, Hyogo 6638501, Japan

[2] Hiroshima Prefectural Hosp, Dept Neurosurg & Neuroendovasc Therapy, Hiroshima, Japan

[3] Kobe City Med Ctr Gen Hosp, Dept Neurosurg, Kobe, Hyogo, Japan

[4] Natl Cerebral & Cardiovasc Ctr, Div Stroke Care Unit, Suita, Osaka, Japan

[5] Natl Hosp Org Osaka Natl Hosp, Dept Stroke Neurol, Osaka, Japan

[6] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

来源：

CEREBROVASCULAR DISEASES | 2019年 / 48卷 / 1-2期

关键词：

Cardioembolic ischemic stroke; Decompressive hemicraniectomy; Endovascular treatment; Proximal intracranial occlusion in the anterior circulation; THROMBECTOMY; IMPLEMENTATION; INFARCTION; FREQUENCY; EMBOLISM; BRAIN;

D O I：

10.1159/000502313

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Cardioembolic stroke is associated with a higher rate of functional limitation, which may be related to the larger ischemic lesion size. Endovascular therapy (EVT) for acute stroke caused by large vessel occlusion reduces severe disabilities. Objectives: We aimed to investigate the relationship between EVT and decompressive hemicraniectomy (DH) in patients with cardioembolic proximal intracranial occlusion in the anterior circulation (CPIOAC) using the data from the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism (RESCUE)-Japan Registry 2. Methods: Among 2,420 patients in the RESCUE-Japan Registry 2, 555 patients aged 20-80 years with acute cardioembolic occlusion of the internal carotid artery and/or the first segment of the middle cerebral artery were included. The primary outcome was DH. Secondary outcomes were any type of intracranial hemorrhage, symptomatic intracranial hemorrhage indicating neurological worsening of >4 points on the National Institutes of Health Stroke Scale within 72 h after the onset of stroke, and recurrence of stroke or transient ischemic attack (TIA) within 90 days. Results: The median age was 73 years (66-77 years), and 360 patients (65%) were male. DH was performed in 1 of 374 patients in the EVT group and 5 of 181 patients in the no-EVT group (p = 0.032). The incidence of any type of intracranial hemorrhage and symptomatic intracranial hemorrhage within 72 h and recurrence of stroke or TIA within 90 days were similar between both groups. Conclusions: EVT may reduce DH in patients with CPIOAC without increasing intracranial hemorrhage.

引用

页码：9 / 16

页数：8

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