Futile recanalization is associated with increased risk of post-stroke epilepsy.

Autor: Lattanzi S; Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy; IRCCS INRCA, Ancona, Italy. Electronic address: alfierelattanzisimona@gmail.com., Cuccurullo C; Neurology and Stroke Unit, Ospedale del Mare Hospital, ASL Napoli 1, Naples, Italy., Orlandi N; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy; Department of Biomedical, Metabolic and Neural Science, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy., Borzì G; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy; Stroke Unit, OCB Hospital, AOU, Modena, Italy., Bigliardi G; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy; Stroke Unit, OCB Hospital, AOU, Modena, Italy., Maffei S; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy; Stroke Unit, OCB Hospital, AOU, Modena, Italy., Giovannini G; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy., Meletti S; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy.
Jazyk: angličtina
Zdroj: Journal of the neurological sciences [J Neurol Sci] 2024 Jul 15; Vol. 462, pp. 123067. Date of Electronic Publication: 2024 May 28.
DOI: 10.1016/j.jns.2024.123067
Abstrakt: Background: Endovascular treatment (EVT) is the standard of care of ischaemic stroke due to occlusion of large vessels. Although EVT can significantly improve short- and long-term outcomes, functional dependence can persist despite the achievement of a successful recanalization. The evidence about the predictors of post-stroke epilepsy (PSE) in patients with stroke treated by EVT is limited. We aimed to evaluate the relationship between futile recanalization and the risk of PSE.
Methods: We retrospectively identified consecutive adults with first-ever ischaemic stroke of anterior circulation who were treated with EVT. Futile recanalization was defined as poor 3-month functional status (modified Rankin scale score ≥ 3) despite complete or near-complete recanalization. Study outcome was the occurrence of PSE during the follow-up.
Results: The study included 327 patients with anterior circulation ischaemic stroke treated with EVT. Futile recanalization occurred in 116 (35.5%) patients and 26 (8.0%) developed PSE during a median follow-up of 35 [interquartile range, 22.7-55.2] months. Futile recanalization was more common among patients who developed PSE compared to those who did not (76.9% versus 31.9%; p < 0.001). Futile recanalization [hazard ratio (HR) = 5.63, 95% confidence interval (CI): 1.88-16.84; p = 0.002], large artery atherosclerosis (HR = 3.48, 95% CI: 1.44-8.40; p = 0.006), cortical involvement (HR = 15.51, 95% CI: 2.06-116.98; p = 0.008), and acute symptomatic status epilepticus (HR = 14.40, 95% CI: 2.80-73.98; p = 0.001) increased the risk of PSE.
Conclusions: Futile recanalization after EVT is associated with increased risk of PSE in patients with ischaemic stroke due to occlusion of large vessel of the anterior circulation.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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