Clinical outcome after thrombectomy in patients with MeVO stroke: importance of clinical and technical factors.

Autor: Nome T; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Enriquez B; Department of Neurology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Nome CG; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.; Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, GliaLab and Letten Centre, University of Oslo, Oslo, Norway., Tennøe B; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Lund CG; Department of Neurology, Oslo University Hospital, Oslo, Norway., Skjelland M; Department of Neurology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Aamodt AH; Department of Neurology, Oslo University Hospital, Oslo, Norway. a.h.aamodt@medisin.uio.no.; Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology, Trondheim, Norway. a.h.aamodt@medisin.uio.no., Beyer M; Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2024 Feb; Vol. 271 (2), pp. 877-886. Date of Electronic Publication: 2023 Oct 17.
DOI: 10.1007/s00415-023-12025-1
Abstrakt: Background and Aims: Whereas high-level evidence has been proven for safety and efficacy of endovascular treatment (EVT) in large vessel occlusion (LVO) stroke, the evidence for EVT in medium vessel occlusion (MeVO) in both sexes and different age groupremains to be answered. The aim of this study was to evaluate the importance of clinical and technical parameters, focusing on sex, age and EVT procedural factors, on functional outcome in primary MeVO (pMeVO) strokes.
Methods: 144 patients with pMeVO in the MCA territory from the Oslo Acute Reperfusion Stroke Study (OSCAR) were included. Clinical and radiological data were collected including 90-day mRS follow-up.
Results: Successful reperfusion with modified thrombolysis in cerebral infarction (mTICI) ≥ 2b was achieved in 123 patients (84%). Good functional outcome (mRS ≤ 2) at 90-day follow-up was achieved in 84 patients (61.8%). Two or more passes with stent retriever was associated with increased risk of SAH, poor mTICI and poor functional outcome. In average, women had 62 min longer ictus to recanalization time compared to men. Age over 80 years was significantly associated with poor outcome and death.
Conclusion: In pMeVO patients, TICI score and number of passes with stent retriever were the main technical factors predicting mRS ≤ 2. Good clinical outcome occurred almost twice as often in patients under 80 years of age compared to patients over 80 years. Women with MeVO strokes had significant longer time from ictus to recanalization; however, this did not affect the clinical outcome.
(© 2023. The Author(s).)
Databáze: MEDLINE
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