Universität zu Köln

Fischer, Sebastian, Goertz, Lukas, Weyland, Charlotte S. ORCID: 0000-0002-1374-7854, Khanafer, Ali, Maurer, Christoph J., Zimmermann, Hanna, Fischer, Thomas David, Styczen, Hanna, Tan, Benjamin, Alexandrou, Maria, Lobsien, Donald, Lobsien, Elmar, Thormann, Maximilian, Meyer, Lukas ORCID: 0000-0002-3776-638X, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Fiehler, Jens, Mpotsaris, Anastasios, Papanagiotou, Panagiotis ORCID: 0000-0002-3124-1398, Yeo, Leonard, Deuschl, Cornelius, Liebig, Thomas, Berlis, Ansgar, Henkes, Hans, Moehlenbruch, Markus and Maus, Volker (2022). Functional Aplasia of the Contralateral A1 Segment Influences Clinical Outcome in Patients with Occlusion of the Distal Internal Carotid Artery. J. Clin. Med., 11 (5). BASEL: MDPI. ISSN 2077-0383

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Abstract

Background: The importance of an A1 aplasia remains unclear in stroke patients. In this work, we analyze the impact of an A1 aplasia contralateral to an acute occlusion of the distal internal carotid artery (ICA) on clinical outcomes. Methods: We conducted a retrospective study of consecutive stroke patients treated with mechanical thrombectomy at 12 tertiary care centers between January 2015 and February 2021 due to an occlusion of the distal ICA. Functional A1 aplasia was defined as the absence of A1 or hypoplastic A1 (>50% reduction to the contralateral site). Functional independence was measured by the modified Rankin Scale (mRS <= 2). Results: In total, 81 out of 1068 (8%) patients had functional A1 aplasia contralateral to distal ICA occlusion. Patients with functional contralateral A1 aplasia were more severely affected on admission (median NIHSS 18, IQR 15-23 vs. 17, IQR 13-21; aOR: 0.672, 95% CI: 0.448-1.007, p = 0.054) and post-interventional ischemic damage was larger (median ASPECTS 5, IQR 1-7, vs. 6, IQR 3-8; aOR: 1.817, 95% CI: 1.184-2.789, p = 0.006). Infarction occurred more often within the ipsilateral ACA territory (20/76, 26% vs. 110/961, 11%; aOR: 2.482, 95% CI: 1.389-4.437, p = 0.002) and both ACA territories (8/76, 11% vs. 5/961, 1%; aOR: 17.968, 95% CI: 4.979-64.847, p <= 0.001). Functional contralateral A1 aplasia was associated with a lower rate of functional independence at discharge (6/81, 8% vs. 194/965, 20%; aOR: 2.579, 95% CI: 1.086-6.122, p = 0.032) and after 90 days (5/55, 9% vs. 170/723, 24%; aOR: 2.664, 95% CI: 1.031-6.883, p = 0.043). Conclusions: A functional A1 aplasia contralateral to a distal ICA occlusion is associated with a poorer clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fischer, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Weyland, Charlotte S. UNSPECIFIED orcid.org/0000-0002-1374-7854 UNSPECIFIED Khanafer, Ali UNSPECIFIED UNSPECIFIED UNSPECIFIED Maurer, Christoph J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmermann, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Thomas David UNSPECIFIED UNSPECIFIED UNSPECIFIED Styczen, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Tan, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Alexandrou, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Lobsien, Donald UNSPECIFIED UNSPECIFIED UNSPECIFIED Lobsien, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Thormann, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Lukas UNSPECIFIED orcid.org/0000-0002-3776-638X UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Fiehler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED UNSPECIFIED UNSPECIFIED Papanagiotou, Panagiotis UNSPECIFIED orcid.org/0000-0002-3124-1398 UNSPECIFIED Yeo, Leonard UNSPECIFIED UNSPECIFIED UNSPECIFIED Deuschl, Cornelius UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlis, Ansgar UNSPECIFIED UNSPECIFIED UNSPECIFIED Henkes, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Moehlenbruch, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-692840
DOI:	10.3390/jcm11051293
Journal or Publication Title:	J. Clin. Med.
Volume:	11
Number:	5
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2077-0383
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THROMBECTOMY; STROKE Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69284