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Title: Procedural Predictors of Outcome in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke

Abstract

Purpose: To identify factors impacting outcome in patients undergoing interventions for acute ischemic stroke (AIS). Materials and Methods: This was a retrospective analysis of patients undergoing endovascular therapy for AIS secondary during a 30 month period. Outcome was based on modified Rankin score at 3- to 6-month follow-up. Recanalization was defined as Thrombolysis in myocardial infarction score 2 to 3. Collaterals were graded based on pial circulation from the anterior cerebral artery either from an ipsilateral injection in cases of middle cerebral artery (MCA) occlusion or contralateral injection for internal carotid artery terminus (ICA) occlusion as follows: no collaterals (grade 0), some collaterals with retrograde opacification of the distal MCA territory (grade 1), and good collaterals with filling of the proximal MCA (M2) branches or retrograde opacification up to the occlusion site (grade 2). Occlusion site was divided into group 1 (ICA), group 2 (MCA with or without contiguous M2 involvement), and group 3 (isolated M2 or M3 branch occlusion). Results: A total of 89 patients were studied. Median age and National Institutes of health stroke scale (NIHSS) score was 71 and 15 years, respectively. Favorable outcome was seen in 49.4% of patients and mortality in 25.8% of patients. Youngermore » age (P = 0.006), lower baseline NIHSS score (P = 0.001), successful recanalization (P < 0.0001), collateral support (P = 0.0008), distal occlusion (P = 0.001), and shorter procedure duration (P = 0.01) were associated with a favorable outcome. Factors affecting successful recanalization included younger age (P = 0.01), lower baseline NIHSS score (P = 0.05), collateral support (P = 0.01), and shorter procedure duration (P = 0.03). An ICA terminus occlusion (P < 0.0001), lack of collaterals (P = 0.0003), and unsuccessful recanalization (P = 0.005) were significantly associated with mortality. Conclusion: Angiographic findings and preprocedure variables can help prognosticate procedure outcomes in patients undergoing endovascular therapy for AIS.« less

Authors:
;  [1];  [2]
  1. West Virginia University Health Sciences Center, Interventional Neuroradiology (United States)
  2. West Virginia University Health Sciences Center, Department of Community Medicine (United States)
Publication Date:
OSTI Identifier:
22066515
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 35; Journal Issue: 6; Other Information: Copyright (c) 2012 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CAROTID ARTERIES; CEREBRAL ARTERIES; INJECTION; MORTALITY; MYOCARDIAL INFARCTION; PATIENTS; RADIOTHERAPY

Citation Formats

Rai, Ansaar T., E-mail: ansaar.rai@gmail.com, Jhadhav, Yahodeep, Domico, Jennifer, and Hobbs, Gerald R. Procedural Predictors of Outcome in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke. United States: N. p., 2012. Web. doi:10.1007/S00270-011-0323-7.
Rai, Ansaar T., E-mail: ansaar.rai@gmail.com, Jhadhav, Yahodeep, Domico, Jennifer, & Hobbs, Gerald R. Procedural Predictors of Outcome in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke. United States. https://doi.org/10.1007/S00270-011-0323-7
Rai, Ansaar T., E-mail: ansaar.rai@gmail.com, Jhadhav, Yahodeep, Domico, Jennifer, and Hobbs, Gerald R. 2012. "Procedural Predictors of Outcome in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke". United States. https://doi.org/10.1007/S00270-011-0323-7.
@article{osti_22066515,
title = {Procedural Predictors of Outcome in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke},
author = {Rai, Ansaar T., E-mail: ansaar.rai@gmail.com and Jhadhav, Yahodeep and Domico, Jennifer and Hobbs, Gerald R},
abstractNote = {Purpose: To identify factors impacting outcome in patients undergoing interventions for acute ischemic stroke (AIS). Materials and Methods: This was a retrospective analysis of patients undergoing endovascular therapy for AIS secondary during a 30 month period. Outcome was based on modified Rankin score at 3- to 6-month follow-up. Recanalization was defined as Thrombolysis in myocardial infarction score 2 to 3. Collaterals were graded based on pial circulation from the anterior cerebral artery either from an ipsilateral injection in cases of middle cerebral artery (MCA) occlusion or contralateral injection for internal carotid artery terminus (ICA) occlusion as follows: no collaterals (grade 0), some collaterals with retrograde opacification of the distal MCA territory (grade 1), and good collaterals with filling of the proximal MCA (M2) branches or retrograde opacification up to the occlusion site (grade 2). Occlusion site was divided into group 1 (ICA), group 2 (MCA with or without contiguous M2 involvement), and group 3 (isolated M2 or M3 branch occlusion). Results: A total of 89 patients were studied. Median age and National Institutes of health stroke scale (NIHSS) score was 71 and 15 years, respectively. Favorable outcome was seen in 49.4% of patients and mortality in 25.8% of patients. Younger age (P = 0.006), lower baseline NIHSS score (P = 0.001), successful recanalization (P < 0.0001), collateral support (P = 0.0008), distal occlusion (P = 0.001), and shorter procedure duration (P = 0.01) were associated with a favorable outcome. Factors affecting successful recanalization included younger age (P = 0.01), lower baseline NIHSS score (P = 0.05), collateral support (P = 0.01), and shorter procedure duration (P = 0.03). An ICA terminus occlusion (P < 0.0001), lack of collaterals (P = 0.0003), and unsuccessful recanalization (P = 0.005) were significantly associated with mortality. Conclusion: Angiographic findings and preprocedure variables can help prognosticate procedure outcomes in patients undergoing endovascular therapy for AIS.},
doi = {10.1007/S00270-011-0323-7},
url = {https://www.osti.gov/biblio/22066515}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 6,
volume = 35,
place = {United States},
year = {Sat Dec 15 00:00:00 EST 2012},
month = {Sat Dec 15 00:00:00 EST 2012}
}