Benefit from successful recanalization in an Italian cohort of stroke patients receiving endovascular treatments according to the DIRECT-MT trial criteria.

Autor:	Cappellari M; Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Saia V; Neurology and Stroke Unit, S. Corona Hospital, Pietra Ligure, Italy., Pracucci G; Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy., Sallustio F; Stroke Unit, Policlinico Tor Vergata, Roma, Italy., Zini A; Neurologia e Rete Stroke metropolitana Ospedale Maggiore IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy., Bergui M; Interventional Neuroradiology Unit, Città della Salute e della Scienza - Molinette, Turin, Italy., Zivelonghi C; Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Mangiafico S; Interventional Neurovascular Unit, Careggi University Hospital, Florence, Italy., Toni D; Emergency Department Stroke Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences [Interv Neuroradiol] 2023 Jun; Vol. 29 (3), pp. 291-300. Date of Electronic Publication: 2022 Mar 14.
DOI:	10.1177/15910199221086429
Abstrakt:	Introduction: To identify predictors of 3-month mRS score and to estimate the benefit from successful recanalization across baseline subgroups of Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) cohort of stroke patients receiving endovascular treatments according to the DIRECT-MT criteria. Methods: Using a model of propensity score matching, we retrospectively identified an IRETAS cohort of 137 patients receiving bridging who were matched with 137 patients receiving MT alone according to the DIRECT-MT criteria. Results: Differences were found between DIRECT-MT and IRETAS cohorts for 3-month mRS score 0 to 1 (23.5% vs. 33.1%) and 0 to 2 (36.7% vs. 47.1%), successful (82% vs. 76.7%) and complete recanalization (32.3% vs. 58.8%). Among unfavorable predictors for 3-month mRS shift, diabetes mellitus (18.9% vs. 13.9%) and asymptomatic intracerebral hemorhage (ICH) (34.8% vs. 25.5%) were more frequent in the DIRECT-MT, whereas age ≥80 years (23.7% vs. 15.3%) and pre-stroke mRS score >0 (16.1% vs. 7.8%) were more frequent in the IRETAS.The direction of effect on the 3-month mRS shift (6 to 0) favored successful recanalization across all strata. Greatest benefit from successful recanalization was observed in patients with most severe strokes (NIHSS ≥20, OR:4.002; 16-19, OR:3.292; 2-5, OR:2.470) and most proximal occlusion site (intra-cranial ICA, OR:4.092; M1-MCA, OR:3.705; M2-MCA, OR:2.001), in younger patients (18-59 years, OR:3.677; 60-79, OR:3.267; ≥80, OR:1.993), and in patients who started the treatment earlier (onset-to-groin time ≤205 min, OR:4.361; onset-to-groin time >205, OR:2.326). Conclusions: The benefit from successful recanalization for 3-month mRS shift in the direction of favorable outcome was different across baseline subgroups.
Databáze:	MEDLINE
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