Good recanalization is associated with long term favorable outcomes in acute stroke patients with large vessel occlusion treated with endovascular therapy
The long-term outcome in acute stroke patients with large vessel occlusion (LVO) treated with endovascular therapy (EVT) are unclear. We investigated functional outcomes one year after EVT in acute stroke patients with LVO. We retrospectively enrolled 149 stroke patients with LVO who underwent EVT f...
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| Veröffentlicht in: | Journal of the neurological sciences 2020-09, Vol.416, p.117009-117009, Article 117009 |
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| container_title | Journal of the neurological sciences |
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| creator | Arakawa, Masafumi Suzuki, Kentaro Kutsuna, Akihito Katano, Takehiro Kanamaru, Takuya Aoki, Junya Sakamoto, Yuki Suda, Satoshi Kimura, Kazumi |
| description | The long-term outcome in acute stroke patients with large vessel occlusion (LVO) treated with endovascular therapy (EVT) are unclear. We investigated functional outcomes one year after EVT in acute stroke patients with LVO.
We retrospectively enrolled 149 stroke patients with LVO who underwent EVT from our prospective stroke registry. We assessed modified Rankin Scale (mRS) scores at one year from onset. The degree of recanalization was evaluated using modified thrombolysis in cerebral infarction (mTICI) grades. Good recanalization and a favorable outcome were defined as an mTICI grade ≥ 2b and mRS score ≤ 2, respectively.
Favorable outcomes were observed in 76 (51.0%) patients. The favorable outcome group was younger (median age: 72 [interquartile range, 63–79] years vs. 79 [70–84] years, P |
| doi_str_mv | 10.1016/j.jns.2020.117009 |
| format | Article |
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We retrospectively enrolled 149 stroke patients with LVO who underwent EVT from our prospective stroke registry. We assessed modified Rankin Scale (mRS) scores at one year from onset. The degree of recanalization was evaluated using modified thrombolysis in cerebral infarction (mTICI) grades. Good recanalization and a favorable outcome were defined as an mTICI grade ≥ 2b and mRS score ≤ 2, respectively.
Favorable outcomes were observed in 76 (51.0%) patients. The favorable outcome group was younger (median age: 72 [interquartile range, 63–79] years vs. 79 [70–84] years, P < .001) and had more male patients (79% vs. 60%, P = .013), lower National Institutes of Health Stroke Scale scores at admission (median 14 [7–18]) vs. 19 [15–25], P < .001), higher DWI-ASPECTS upon admission (median [6–9] vs. 6 [4–8], P = .022), more patients with mTICI ≥ 2b (93% vs. 64%, P < .001) and fewer post-therapy intracranial cerebral hemorrhages (13% vs. 29%, P = .019) than the poor outcome group. In our multivariate analysis, mTICI ≥ 2b were independently associated with favorable outcomes at one year from onset (odds ratio, 10.282; 95% confidence interval, 1.587–66.604; P = .015).
Good recanalization was associated with favorable functional outcomes one year after EVT in acute stroke patients with LVO.
•The number of patients with mRS score ≤ 2 at 90 days did not decrease at one year.•Favorable outcomes one-year from onset were associated with mTICI grade ≥ 2b.•DWI-ASPECTS on arrival was high in the favorable outcome group.•Good recanalization should be associated with good functional outcomes.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2020.117009</identifier><identifier>PMID: 32650144</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Acute ischemic stroke ; Aged ; Brain Ischemia - complications ; Brain Ischemia - diagnostic imaging ; Brain Ischemia - therapy ; Endovascular Procedures ; Endovascular therapy ; Humans ; Large vessel occlusion ; Long-term outcome ; Male ; Prospective Studies ; Retrospective Studies ; Stroke - diagnostic imaging ; Stroke - therapy ; Treatment Outcome</subject><ispartof>Journal of the neurological sciences, 2020-09, Vol.416, p.117009-117009, Article 117009</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-f1f46e42d4d9eb26b3bc8b3fe5974d2eb4f5b97d20a3edb8e519e3db8e64fcfe3</citedby><cites>FETCH-LOGICAL-c353t-f1f46e42d4d9eb26b3bc8b3fe5974d2eb4f5b97d20a3edb8e519e3db8e64fcfe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jns.2020.117009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32650144$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arakawa, Masafumi</creatorcontrib><creatorcontrib>Suzuki, Kentaro</creatorcontrib><creatorcontrib>Kutsuna, Akihito</creatorcontrib><creatorcontrib>Katano, Takehiro</creatorcontrib><creatorcontrib>Kanamaru, Takuya</creatorcontrib><creatorcontrib>Aoki, Junya</creatorcontrib><creatorcontrib>Sakamoto, Yuki</creatorcontrib><creatorcontrib>Suda, Satoshi</creatorcontrib><creatorcontrib>Kimura, Kazumi</creatorcontrib><title>Good recanalization is associated with long term favorable outcomes in acute stroke patients with large vessel occlusion treated with endovascular therapy</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>The long-term outcome in acute stroke patients with large vessel occlusion (LVO) treated with endovascular therapy (EVT) are unclear. We investigated functional outcomes one year after EVT in acute stroke patients with LVO.
We retrospectively enrolled 149 stroke patients with LVO who underwent EVT from our prospective stroke registry. We assessed modified Rankin Scale (mRS) scores at one year from onset. The degree of recanalization was evaluated using modified thrombolysis in cerebral infarction (mTICI) grades. Good recanalization and a favorable outcome were defined as an mTICI grade ≥ 2b and mRS score ≤ 2, respectively.
Favorable outcomes were observed in 76 (51.0%) patients. The favorable outcome group was younger (median age: 72 [interquartile range, 63–79] years vs. 79 [70–84] years, P < .001) and had more male patients (79% vs. 60%, P = .013), lower National Institutes of Health Stroke Scale scores at admission (median 14 [7–18]) vs. 19 [15–25], P < .001), higher DWI-ASPECTS upon admission (median [6–9] vs. 6 [4–8], P = .022), more patients with mTICI ≥ 2b (93% vs. 64%, P < .001) and fewer post-therapy intracranial cerebral hemorrhages (13% vs. 29%, P = .019) than the poor outcome group. In our multivariate analysis, mTICI ≥ 2b were independently associated with favorable outcomes at one year from onset (odds ratio, 10.282; 95% confidence interval, 1.587–66.604; P = .015).
Good recanalization was associated with favorable functional outcomes one year after EVT in acute stroke patients with LVO.
•The number of patients with mRS score ≤ 2 at 90 days did not decrease at one year.•Favorable outcomes one-year from onset were associated with mTICI grade ≥ 2b.•DWI-ASPECTS on arrival was high in the favorable outcome group.•Good recanalization should be associated with good functional outcomes.</description><subject>Acute ischemic stroke</subject><subject>Aged</subject><subject>Brain Ischemia - complications</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Brain Ischemia - therapy</subject><subject>Endovascular Procedures</subject><subject>Endovascular therapy</subject><subject>Humans</subject><subject>Large vessel occlusion</subject><subject>Long-term outcome</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - therapy</subject><subject>Treatment Outcome</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhi1ERYfCA7BBXrLJ4FsyiVihqi1IldgUiZ3ly3HrIYkHH2dQ-yg8LR7NADtWtqXv_61zPkLecLbmjHfvt-vtjGvBRH3zDWPDM7Li_aZv2r6Xz8mKMSGalrNv5-Ql4pYx1vX98IKcS9G1jCu1Ir9uUvI0gzOzGeOTKTHNNCI1iMlFU8DTn7E80DHN97RAnmgw-5SNHYGmpbg0AdI4U-OWAhRLTt-B7moNzAVPUZPvge4BEUaanBsXPHxSMvyrh9mnvUG3VJiWB8hm9_iKnAUzIrw-nRfk6_XV3eWn5vbLzefLj7eNk60sTeBBdaCEV34AKzorreutDNAOG-UFWBVaO2y8YEaCtz20fAB5uHQquADygrw79u5y-rEAFj1FdDCOZoa0oBZKyLo4JURF-RF1OSFmCHqX42Tyo-ZMH5Tora5K9EGJPiqpmben-sVO4P8m_jiowIcjAHXIfYSs0dX1OfCxeinap_if-t8ZDKII</recordid><startdate>20200915</startdate><enddate>20200915</enddate><creator>Arakawa, Masafumi</creator><creator>Suzuki, Kentaro</creator><creator>Kutsuna, Akihito</creator><creator>Katano, Takehiro</creator><creator>Kanamaru, Takuya</creator><creator>Aoki, Junya</creator><creator>Sakamoto, Yuki</creator><creator>Suda, Satoshi</creator><creator>Kimura, Kazumi</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200915</creationdate><title>Good recanalization is associated with long term favorable outcomes in acute stroke patients with large vessel occlusion treated with endovascular therapy</title><author>Arakawa, Masafumi ; Suzuki, Kentaro ; Kutsuna, Akihito ; Katano, Takehiro ; Kanamaru, Takuya ; Aoki, Junya ; Sakamoto, Yuki ; Suda, Satoshi ; Kimura, Kazumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-f1f46e42d4d9eb26b3bc8b3fe5974d2eb4f5b97d20a3edb8e519e3db8e64fcfe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute ischemic stroke</topic><topic>Aged</topic><topic>Brain Ischemia - complications</topic><topic>Brain Ischemia - diagnostic imaging</topic><topic>Brain Ischemia - therapy</topic><topic>Endovascular Procedures</topic><topic>Endovascular therapy</topic><topic>Humans</topic><topic>Large vessel occlusion</topic><topic>Long-term outcome</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arakawa, Masafumi</creatorcontrib><creatorcontrib>Suzuki, Kentaro</creatorcontrib><creatorcontrib>Kutsuna, Akihito</creatorcontrib><creatorcontrib>Katano, Takehiro</creatorcontrib><creatorcontrib>Kanamaru, Takuya</creatorcontrib><creatorcontrib>Aoki, Junya</creatorcontrib><creatorcontrib>Sakamoto, Yuki</creatorcontrib><creatorcontrib>Suda, Satoshi</creatorcontrib><creatorcontrib>Kimura, Kazumi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arakawa, Masafumi</au><au>Suzuki, Kentaro</au><au>Kutsuna, Akihito</au><au>Katano, Takehiro</au><au>Kanamaru, Takuya</au><au>Aoki, Junya</au><au>Sakamoto, Yuki</au><au>Suda, Satoshi</au><au>Kimura, Kazumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Good recanalization is associated with long term favorable outcomes in acute stroke patients with large vessel occlusion treated with endovascular therapy</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2020-09-15</date><risdate>2020</risdate><volume>416</volume><spage>117009</spage><epage>117009</epage><pages>117009-117009</pages><artnum>117009</artnum><issn>0022-510X</issn><eissn>1878-5883</eissn><abstract>The long-term outcome in acute stroke patients with large vessel occlusion (LVO) treated with endovascular therapy (EVT) are unclear. We investigated functional outcomes one year after EVT in acute stroke patients with LVO.
We retrospectively enrolled 149 stroke patients with LVO who underwent EVT from our prospective stroke registry. We assessed modified Rankin Scale (mRS) scores at one year from onset. The degree of recanalization was evaluated using modified thrombolysis in cerebral infarction (mTICI) grades. Good recanalization and a favorable outcome were defined as an mTICI grade ≥ 2b and mRS score ≤ 2, respectively.
Favorable outcomes were observed in 76 (51.0%) patients. The favorable outcome group was younger (median age: 72 [interquartile range, 63–79] years vs. 79 [70–84] years, P < .001) and had more male patients (79% vs. 60%, P = .013), lower National Institutes of Health Stroke Scale scores at admission (median 14 [7–18]) vs. 19 [15–25], P < .001), higher DWI-ASPECTS upon admission (median [6–9] vs. 6 [4–8], P = .022), more patients with mTICI ≥ 2b (93% vs. 64%, P < .001) and fewer post-therapy intracranial cerebral hemorrhages (13% vs. 29%, P = .019) than the poor outcome group. In our multivariate analysis, mTICI ≥ 2b were independently associated with favorable outcomes at one year from onset (odds ratio, 10.282; 95% confidence interval, 1.587–66.604; P = .015).
Good recanalization was associated with favorable functional outcomes one year after EVT in acute stroke patients with LVO.
•The number of patients with mRS score ≤ 2 at 90 days did not decrease at one year.•Favorable outcomes one-year from onset were associated with mTICI grade ≥ 2b.•DWI-ASPECTS on arrival was high in the favorable outcome group.•Good recanalization should be associated with good functional outcomes.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>32650144</pmid><doi>10.1016/j.jns.2020.117009</doi><tpages>1</tpages></addata></record> |
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| ispartof | Journal of the neurological sciences, 2020-09, Vol.416, p.117009-117009, Article 117009 |
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| subjects | Acute ischemic stroke Aged Brain Ischemia - complications Brain Ischemia - diagnostic imaging Brain Ischemia - therapy Endovascular Procedures Endovascular therapy Humans Large vessel occlusion Long-term outcome Male Prospective Studies Retrospective Studies Stroke - diagnostic imaging Stroke - therapy Treatment Outcome |
| title | Good recanalization is associated with long term favorable outcomes in acute stroke patients with large vessel occlusion treated with endovascular therapy |
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