Patient selection for mechanical thrombectomy in posterior circulation emergent large-vessel occlusion
| Autor: | Scott B. Raymond, Ramon G. Gonzalez, Thabele M Leslie-Mazwi, Pamela W. Schaefer, James D. Rabinov, Joshua A Hirsch, Natalia S. Rost |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Stuttering 03 medical and health sciences 0302 clinical medicine Internal medicine Occlusion medicine Humans 030212 general & internal medicine Registries Stroke Selection (genetic algorithm) Aged Retrospective Studies Thrombectomy business.industry Patient Selection Clinical course Middle Aged medicine.disease Prognosis Triage Magnetic Resonance Imaging Cerebral Angiography Mechanical thrombectomy Treatment Outcome Basilar Artery Cardiology Female medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery Algorithms Large vessel occlusion |
| Zdroj: | Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. 24(3) |
| ISSN: | 2385-2011 |
| Popis: | Triage of posterior circulation stroke from emergent large-vessel occlusion (pc-ELVO) is challenging owing to the stuttering clinical course and potential for rapid decline. Growing clinical data support the use of mechanical thrombectomy in pc-ELVO, but there are limited data addressing the clinical and imaging criteria for patient selection. We present our triage algorithm used to select patients for endovascular therapy (EVT) in the setting of pc-ELVOS. We use a consecutive retrospective database from 2004 to 2016 to describe the practice patterns and prognostic factors for pc-ELVO patients treated using both medical and EVT. Patients with moderate to severe deficits (NIHSS > 10) did better when they received EVT ( p 10), most of whom subsequently received EVT (9 of 12), with 56% favorable outcomes. Cerebellar and brainstem infarct volumes were independent imaging predictors of outcome. These results can be used to define triage criteria for use of EVT in pc-ELVO in future practice and clinical trials. |
| Databáze: | OpenAIRE |
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