Universität zu Köln

Maus, Volker, You, Seunghwa, Kalkan, Alev, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Kabbasch, Christoph, Barnikol, Utako Birgit, Stetefeld, Henning, Dohmen, Christian, Liebig, Thomas, Fink, Gereon Rudolf and Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 (2017). Incomplete Large Vessel Occlusions in Mechanical Thrombectomy: An Independent Predictor of Favorable Outcome in Ischemic Stroke. Cerebrovasc. Dis., 44 (3-4). S. 113 - 122. BASEL: KARGER. ISSN 1421-9786

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Abstract

Background and Purpose: Cerebral large vessel occlusion (LVO) in acute ischemic stroke (AIS) may be complete (CLVO) or incomplete (ILVO). The influence of ILVO on clinical outcome after mechanical thrombectomy (MT) remains unclear. We investigated primarily the clinical outcome in patients with AIS due to ILVO or CLVO. Methods: Five hundred three consecutive AIS patients with LVO treated with stent-retriever or direct aspiration-based MT between 2010 and 2016 were analyzed. The primary endpoint was favorable clinical outcome (modified Rankin Scale <= 2) at 90 days; secondary endpoints were periprocedural parameters. Results: Forty-nine patients (11.3%) with a median National Institutes of Health Stroke Scale (NIHSS) of 11 presented with ILVO and the remainder presented with CLVO and median NIHSS of 15 (p < 0.001). The median groin puncture-to-reperfusion time was 30 vs. 67 min, respectively (p < 0.001). Successful reperfusion was reached in 47 out of 49 ILVO (95.9%) vs. 298 out of 381 CLVO (78.2%; p < 0.005) with less retrieval maneuvers (1.7 +/- 2.2 vs. 3.0 +/- 2.5; p < 0.001). The favorable outcome at 90 days was 81% in patients with ILVO vs. 29.1% in CLVO (p < 0.001); respective all-cause mortality rates were 6.4 vs. 28.5% (p < 0.001). Periprocedural complications (6.9%) occurred exclusively in CLVO patients (p < 0.05). ILVO was associated with favorable clinical outcome independent of age and NIHSS in multivariate logistic regression both in the anterior (OR 3.6; 95% CI 1.8-6.9; p < 0.001) and posterior circulation (OR 3.5; 95% CI 1.8-6.9; p < 0.001). Conclusions: AIS due to ILVO is frequent and is associated with a nearly threefold higher chance of favorable clinical outcome at 90 days, independent of age and initial NIHSS compared to CLVO. (C) 2017 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED You, Seunghwa UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalkan, Alev UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Barnikol, Utako Birgit UNSPECIFIED UNSPECIFIED UNSPECIFIED Stetefeld, Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon Rudolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-243060
DOI:	10.1159/000477499
Journal or Publication Title:	Cerebrovasc. Dis.
Volume:	44
Number:	3-4
Page Range:	S. 113 - 122
Date:	2017
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9786
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ENDOVASCULAR TREATMENT; INTRAVENOUS THROMBOLYSIS; CONSENSUS STATEMENT; RECANALIZATION; REVASCULARIZATION; SOLITAIRE; REGISTRY; TRIAL; METAANALYSIS; ENDOSTROKE Multiple languages Clinical Neurology; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24306