Outcome of patients with multivessel occlusion stroke after endovascular treatment
Introduction: Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT). Patients and methods: We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who unde...
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| Veröffentlicht in: | European stroke journal 2024-06, Vol.9 (2), p.312-319 |
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| creator | LeCouffe, Natalie E Treurniet, Kilian M Kappelhof, Manon Jansen, Ivo GH Boers, Merel Marquering, Henk A Beenen, Ludo FM Boiten, Jelis van Zwam, Wim H Yo, Lonneke SF Majoie, Charles BLM Roos, Yvo BWEM Emmer, Bart J Coutinho, Jonathan M |
| description | Introduction:
Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).
Patients and methods:
We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014–November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.
Results:
Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p |
| doi_str_mv | 10.1177/23969873231216811 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11318423</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_23969873231216811</sage_id><sourcerecordid>2902940698</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-da9baeccc15f068086e9fa495546766dd9486ccff774d158d383b01bef369ba3</originalsourceid><addsrcrecordid>eNp9UU1LBDEMLaKoqD_Ai_ToZddmOtuPk4j4BYIg3ku3k-rozHRtOyv-eyuriyJ4SULy3kt4IeQQ2BRAypOKa6GV5BWHCoQC2CC7n72JVgo217XkO-QgpWfGGGgQXME22SmRVVKyXXJ_N2YXeqTB04XNLQ450bc2P9F-7HK7xJSwo8G5bkxtGGjKMbwgtT5jpDg0YWmTGzsbaY5oc1_4-2TL2y7hwVfeIw-XFw_n15Pbu6ub87PbieMa8qSxem7ROQczz4RiSqD2ttazWS2kEE2jayWc817KuoGZarjicwZz9FwUJt8jpyvZxTjvsXFlc7SdWcS2t_HdBNua35OhfTKPYWkAOKi64kXh-EshhtcRUzZ9mxx2nR0wjMlUmlW6ZsXlAoUV1MWQUkS_3gPMfL7D_HlH4Rz9PHDN-Da_AKYrQLKPaJ7DGIfi1z-KH8P5lS4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2902940698</pqid></control><display><type>article</type><title>Outcome of patients with multivessel occlusion stroke after endovascular treatment</title><source>Access via SAGE</source><source>PubMed Central Free</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>LeCouffe, Natalie E ; Treurniet, Kilian M ; Kappelhof, Manon ; Jansen, Ivo GH ; Boers, Merel ; Marquering, Henk A ; Beenen, Ludo FM ; Boiten, Jelis ; van Zwam, Wim H ; Yo, Lonneke SF ; Majoie, Charles BLM ; Roos, Yvo BWEM ; Emmer, Bart J ; Coutinho, Jonathan M</creator><creatorcontrib>LeCouffe, Natalie E ; Treurniet, Kilian M ; Kappelhof, Manon ; Jansen, Ivo GH ; Boers, Merel ; Marquering, Henk A ; Beenen, Ludo FM ; Boiten, Jelis ; van Zwam, Wim H ; Yo, Lonneke SF ; Majoie, Charles BLM ; Roos, Yvo BWEM ; Emmer, Bart J ; Coutinho, Jonathan M</creatorcontrib><description>Introduction:
Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).
Patients and methods:
We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014–November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.
Results:
Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25–0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24–3.57).
Discussion and conclusion:
MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome.
Graphical abstract</description><identifier>ISSN: 2396-9873</identifier><identifier>ISSN: 2396-9881</identifier><identifier>EISSN: 2396-9881</identifier><identifier>DOI: 10.1177/23969873231216811</identifier><identifier>PMID: 38102770</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Endovascular Procedures - adverse effects ; Endovascular Procedures - methods ; Female ; Humans ; Infarction, Middle Cerebral Artery - diagnostic imaging ; Infarction, Middle Cerebral Artery - mortality ; Infarction, Middle Cerebral Artery - surgery ; Male ; Middle Aged ; Netherlands - epidemiology ; Original s ; Prospective Studies ; Registries ; Stroke - mortality ; Stroke - therapy ; Treatment Outcome</subject><ispartof>European stroke journal, 2024-06, Vol.9 (2), p.312-319</ispartof><rights>European Stroke Organisation 2023</rights><rights>European Stroke Organisation 2023 2023 European Stroke Organisation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c391t-da9baeccc15f068086e9fa495546766dd9486ccff774d158d383b01bef369ba3</cites><orcidid>0000-0002-6668-8755 ; 0000-0001-9205-5882 ; 0000-0001-9204-1026 ; 0000-0003-1631-7056</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318423/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318423/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,21824,27929,27930,43626,43627,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38102770$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LeCouffe, Natalie E</creatorcontrib><creatorcontrib>Treurniet, Kilian M</creatorcontrib><creatorcontrib>Kappelhof, Manon</creatorcontrib><creatorcontrib>Jansen, Ivo GH</creatorcontrib><creatorcontrib>Boers, Merel</creatorcontrib><creatorcontrib>Marquering, Henk A</creatorcontrib><creatorcontrib>Beenen, Ludo FM</creatorcontrib><creatorcontrib>Boiten, Jelis</creatorcontrib><creatorcontrib>van Zwam, Wim H</creatorcontrib><creatorcontrib>Yo, Lonneke SF</creatorcontrib><creatorcontrib>Majoie, Charles BLM</creatorcontrib><creatorcontrib>Roos, Yvo BWEM</creatorcontrib><creatorcontrib>Emmer, Bart J</creatorcontrib><creatorcontrib>Coutinho, Jonathan M</creatorcontrib><title>Outcome of patients with multivessel occlusion stroke after endovascular treatment</title><title>European stroke journal</title><addtitle>Eur Stroke J</addtitle><description>Introduction:
Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).
Patients and methods:
We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014–November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.
Results:
Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25–0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24–3.57).
Discussion and conclusion:
MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome.
Graphical abstract</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Infarction, Middle Cerebral Artery - diagnostic imaging</subject><subject>Infarction, Middle Cerebral Artery - mortality</subject><subject>Infarction, Middle Cerebral Artery - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Original s</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Stroke - mortality</subject><subject>Stroke - therapy</subject><subject>Treatment Outcome</subject><issn>2396-9873</issn><issn>2396-9881</issn><issn>2396-9881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>EIF</sourceid><recordid>eNp9UU1LBDEMLaKoqD_Ai_ToZddmOtuPk4j4BYIg3ku3k-rozHRtOyv-eyuriyJ4SULy3kt4IeQQ2BRAypOKa6GV5BWHCoQC2CC7n72JVgo217XkO-QgpWfGGGgQXME22SmRVVKyXXJ_N2YXeqTB04XNLQ450bc2P9F-7HK7xJSwo8G5bkxtGGjKMbwgtT5jpDg0YWmTGzsbaY5oc1_4-2TL2y7hwVfeIw-XFw_n15Pbu6ub87PbieMa8qSxem7ROQczz4RiSqD2ttazWS2kEE2jayWc817KuoGZarjicwZz9FwUJt8jpyvZxTjvsXFlc7SdWcS2t_HdBNua35OhfTKPYWkAOKi64kXh-EshhtcRUzZ9mxx2nR0wjMlUmlW6ZsXlAoUV1MWQUkS_3gPMfL7D_HlH4Rz9PHDN-Da_AKYrQLKPaJ7DGIfi1z-KH8P5lS4</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>LeCouffe, Natalie E</creator><creator>Treurniet, Kilian M</creator><creator>Kappelhof, Manon</creator><creator>Jansen, Ivo GH</creator><creator>Boers, Merel</creator><creator>Marquering, Henk A</creator><creator>Beenen, Ludo FM</creator><creator>Boiten, Jelis</creator><creator>van Zwam, Wim H</creator><creator>Yo, Lonneke SF</creator><creator>Majoie, Charles BLM</creator><creator>Roos, Yvo BWEM</creator><creator>Emmer, Bart J</creator><creator>Coutinho, Jonathan M</creator><general>SAGE Publications</general><scope>AFRWT</scope><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><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6668-8755</orcidid><orcidid>https://orcid.org/0000-0001-9205-5882</orcidid><orcidid>https://orcid.org/0000-0001-9204-1026</orcidid><orcidid>https://orcid.org/0000-0003-1631-7056</orcidid></search><sort><creationdate>20240601</creationdate><title>Outcome of patients with multivessel occlusion stroke after endovascular treatment</title><author>LeCouffe, Natalie E ; Treurniet, Kilian M ; Kappelhof, Manon ; Jansen, Ivo GH ; Boers, Merel ; Marquering, Henk A ; Beenen, Ludo FM ; Boiten, Jelis ; van Zwam, Wim H ; Yo, Lonneke SF ; Majoie, Charles BLM ; Roos, Yvo BWEM ; Emmer, Bart J ; Coutinho, Jonathan M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-da9baeccc15f068086e9fa495546766dd9486ccff774d158d383b01bef369ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Infarction, Middle Cerebral Artery - diagnostic imaging</topic><topic>Infarction, Middle Cerebral Artery - mortality</topic><topic>Infarction, Middle Cerebral Artery - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands - epidemiology</topic><topic>Original s</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Stroke - mortality</topic><topic>Stroke - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LeCouffe, Natalie E</creatorcontrib><creatorcontrib>Treurniet, Kilian M</creatorcontrib><creatorcontrib>Kappelhof, Manon</creatorcontrib><creatorcontrib>Jansen, Ivo GH</creatorcontrib><creatorcontrib>Boers, Merel</creatorcontrib><creatorcontrib>Marquering, Henk A</creatorcontrib><creatorcontrib>Beenen, Ludo FM</creatorcontrib><creatorcontrib>Boiten, Jelis</creatorcontrib><creatorcontrib>van Zwam, Wim H</creatorcontrib><creatorcontrib>Yo, Lonneke SF</creatorcontrib><creatorcontrib>Majoie, Charles BLM</creatorcontrib><creatorcontrib>Roos, Yvo BWEM</creatorcontrib><creatorcontrib>Emmer, Bart J</creatorcontrib><creatorcontrib>Coutinho, Jonathan M</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>European stroke journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LeCouffe, Natalie E</au><au>Treurniet, Kilian M</au><au>Kappelhof, Manon</au><au>Jansen, Ivo GH</au><au>Boers, Merel</au><au>Marquering, Henk A</au><au>Beenen, Ludo FM</au><au>Boiten, Jelis</au><au>van Zwam, Wim H</au><au>Yo, Lonneke SF</au><au>Majoie, Charles BLM</au><au>Roos, Yvo BWEM</au><au>Emmer, Bart J</au><au>Coutinho, Jonathan M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of patients with multivessel occlusion stroke after endovascular treatment</atitle><jtitle>European stroke journal</jtitle><addtitle>Eur Stroke J</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>9</volume><issue>2</issue><spage>312</spage><epage>319</epage><pages>312-319</pages><issn>2396-9873</issn><issn>2396-9881</issn><eissn>2396-9881</eissn><abstract>Introduction:
Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).
Patients and methods:
We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014–November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.
Results:
Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25–0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24–3.57).
Discussion and conclusion:
MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome.
Graphical abstract</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>38102770</pmid><doi>10.1177/23969873231216811</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6668-8755</orcidid><orcidid>https://orcid.org/0000-0001-9205-5882</orcidid><orcidid>https://orcid.org/0000-0001-9204-1026</orcidid><orcidid>https://orcid.org/0000-0003-1631-7056</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | European stroke journal, 2024-06, Vol.9 (2), p.312-319 |
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| subjects | Aged Aged, 80 and over Endovascular Procedures - adverse effects Endovascular Procedures - methods Female Humans Infarction, Middle Cerebral Artery - diagnostic imaging Infarction, Middle Cerebral Artery - mortality Infarction, Middle Cerebral Artery - surgery Male Middle Aged Netherlands - epidemiology Original s Prospective Studies Registries Stroke - mortality Stroke - therapy Treatment Outcome |
| title | Outcome of patients with multivessel occlusion stroke after endovascular treatment |
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