Prognostic Factors for Neurologic Outcome after Endovascular Revascularization of Acute Symptomatic Occlusion of the Internal Carotid Artery

Autor: C. Ahn, K. S. Lim, K. D. Hahm, Choong-Gon Choi, J. G. Leem, Dae Chu Suh, J. S. Kim, Sang Joon Kim, Sun Uck Kwon, Hae Wook Pyun, June-Sung Kim, Dong Hyun Yang, Jung-Bok Lee
Rok vydání: 2007
Předmět:
Zdroj: AJNR Am J Neuroradiol
ISSN: 1936-959X
0195-6108
DOI: 10.3174/ajnr.a0492
Popis: BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion. MATERIALS AND METHODS: We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes. RESULTS: Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42%) of 33 and good recovery (mRS ≤2) after 1 year in 11 (33%) of 33. Distal residual occlusion (DRO; P = .005), initial NIHSS score ( P = .023), and postprocedural thrombolysis in cerebral infarction ( P = .027), retrograde ICA filling ( P = .036), and ophthalmic collaterals ( P = .046) were significant predictors of short-term outcome. DRO ( P = .018) and initial NIHSS ( P = .033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term ( P = .026) and long-term outcome ( P = .033) on multivariable logistic regression. CONCLUSIONS: Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.
Databáze: OpenAIRE