Outcome of a Real-World Cohort of Patients Subjected to Endovascular Treatment for Acute Ischemic Stroke |
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| Affiliation: | 1. ‘‘Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, Milan, Milano 20157, Italy;2. Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy;3. Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza, 28, Milan, Milano 20122, Italy;4. Neurology Unit, Istituto Clinico Città Studi, Via Jommelli 17, Milan, Milano 20131, Italy;5. Neurology Unit, ASST Ovest Milanese, Via Papa Giovanni Paolo II C.P. 3, Legnano 20025, Italy;6. Neurology Unit, ASST Rhodense, V.le Forlanini, 95, Garbagnate Milanese 20024, Italy;7. Neurology Unit, Ospedale Maggiore di Lodi, Piazza Ospitale, 10, Lodi 26900, Italy;8. Department of Neuroscience, Neurology and Stroke Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy;1. Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan;2. Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan;3. Department of Artificial Intelligence in Healthcare and Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan;4. Social Health Medicine Welfare Laboratory, Public Interest Incorporated Association Kyoto Hokenkai, Kyoto, Japan;1. Intensive Care Unit of the Affiliated Huai''an Hospital of Xuzhou Medical University, Huai''an 223001, Jiangsu, China;2. Laboratory of Emergency Medicine, Second Clinical Medical College of Xuzhou Medical University, Xuzhou, 221004, China;3. Emergency Medicine Department of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China;1. Department of Neurology, Mie University Graduate School of Medicine, 2-chome-174 Edobashi, Tsu, Mie 514-0001, Japan;2. Division of Rehabilitation, Mie University Hospital, Tsu, Mie, Japan;3. Department of Emergency and Disaster Medicine, Mie University Graduate School of Medicine, Japan;4. Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Mie, Japan;5. Department of Neurosurgery, Mie University Graduate School of Medicine, Japan;1. Service d''Anesthésie-Réanimation, Hôpital Laënnec, Centre Hospitalier Universitaire, Nantes F-44093, France;2. CHU de Nantes, Inserm CIC 1413, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des Données, Nantes, France;3. Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nantes, Nantes F-44093, France;4. Institut du Thorax, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Université de Nantes, Nantes F-44093, France;1. Department of Internal Medicine, University of Massachusetts Medical School-Baystate Medical Center, Springfield, MA, United States;2. Department of Neurology, The Ohio State University, Columbus, OH, United States;3. Department of Neurology, University of New Mexico Health Sciences Center, MSC10-5620, 1 UNM, 87111, Albuquerque, NM 87131, United States;1. Department of Neurology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan;2. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan |
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| Abstract: | ![]()
ObjectivesIschemic stroke is a leading cause of death and disability worldwide. For patients with large vessel occlusion stroke, endovascular treatment is now the most effective treatment. We aimed to assess the outcome of patients undergoing endovascular treatment for large vessel occlusion stroke in a real-world setting, comparing our results with data from randomized clinical trials, and recognizing the factors associated with prognosis.Materials and methodsWe retrospectively collected data on endovascular procedures performed in one comprehensive stroke center in consecutive patients presenting with large vessel occlusion stroke from January 2017 to January 2020. Data on baseline clinical, imaging, and treatment-related characteristics were recorded. Selection of patients and treatment approach was not standardized but followed current guidelines for ischemic stroke. Functional outcome was evaluated 3 months after endovascular treatment. Clinical, imaging and treatment-related variables associated to outcome were evaluated with univariate and multivariable analyses.ResultsFour hundred twelve patients were included in our study. Three-month functional independence was achieved in 50.5% of patients (50.3% in the anterior stroke and 52.1% in the posterior stroke subgroup). Successful arterial reperfusion was observed in 84.3% of patients. Age (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20–0.87, p = 0.020]), severe stroke at onset (OR 0.40, 95%CI 0.19–0.83), procedure related complications (OR 0.45, 95%CI 0.20–0.99), and good collateral circulation (OR 2.69, 95%CI 1.17–6.16) were associated with 3-month functional independence in multivariable model.ConclusionsOur real-world outcome results are in line with data from large randomized clinical trials on endovascular treatment for large vessel occlusion stroke. |
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