Outcomes and safety of endovascular treatment from 6 to 24 hours in patients with a pre-stroke moderate disability (mRS 3): a multicenter retrospective study.

Autor:	Maestrini I; Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy ilamaestrini@hotmail.com., Rocchi L; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy., Diana F; Interventional Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain.; Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain., Requena Ruiz M; Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain.; Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain., Elosua-Bayes I; Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain.; Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain., Ribo M; Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain.; Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain., Abdalkader M; Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USA., Klein P; Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USA., Gabrieli JD; Department of Neuroradiology, University Hospital of Padova, Padua, Italy., Alexandre AM; UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy., Pedicelli A; UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy.; Catholic University School of Medicine, Institute of Bio-Imaging, Rome, Italy., Lacidogna G; Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy., Ciullo I; Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy., Marnat G; Interventional and Diagnostic Neuroradiology, Bordeaux University Hospital, Bordeaux, France., Cester G; Department of Neuroradiology, University Hospital of Padova, Padua, Italy., Broccolini A; Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy., Nguyen TN; Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USA., Tomasello A; Interventional Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain.; Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain., Garaci F; Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy., Diomedi M; Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy., Da Ros V; Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2024 May 29. Date of Electronic Publication: 2024 May 29.
DOI:	10.1136/jnis-2024-021634
Abstrakt:	Background: Approximately 30% of patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion have pre-stroke modified Rankin Scale (mRS) scores ≥2. We aimed to investigate the safety and outcomes of endovascular treatment (EVT) in patients with AIS with moderate pre-stroke disability (mRS score 3) in an extended time frame (ie, 6-24 hours from the last time known well). Methods: Data were collected from five centers in Europe and the USA from January 2018 to January 2023 and included 180 patients who underwent EVT in an extended time frame. Patients were divided into two groups of 90 each (Group 1: pre-mRS 0-2; Group 2: pre-mRS 3; 71% women, mean age 80.3±11.9 years). Primary outcomes were: (1) 3-month good clinical outcome (Group 1: mRS 0-2, Group 2: mRS 0-3) and ΔmRS; (2) any hemorrhagic transformation (HT); and (3) symptomatic HT. Secondary outcomes were successful and complete recanalization after EVT and 3-month mortality. Results: No between-group differences were found in the 3-month good clinical outcome (26.6% vs 25.5%, P=0.974), any HT (26.6% vs 22%, P=0.733), and symptomatic HT (8.9 vs 4.4%, P=0.232). Unexpectedly, ΔmRS was significantly smaller in Group 2 compared with Group 1 (1.64±1.61 vs 2.97±1.69, P<0.001). No between-group differences were found in secondary outcomes. Conclusion: Patients with pre-stroke mRS 3 are likely to have similar outcomes after EVT in the extended time frame to those with pre-stroke mRS 0-2, with no difference in safety. Competing Interests: Competing interests: T.N. Nguyen discloses advisory board for Brainomix, Aruna Bio; Associate Editor of Stroke. The other authors declare that they have no conflict of interests. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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