1. What predicts poor outcome after successful thrombectomy in early time window?
- Author
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Jean-Marc, Olivot, Jeremy J, Heit, Mikael, Mazighi, Nicolas, Raposo, Jean François, Albucher, Vanessa, Rousseau, Adrien, Guenego, Claire, Thalamas, Michael, Mlynash, Amel, Drif, Soren, Christensen, Agnes, Sommet, Alain, Viguier, Jean, Darcourt, Anne-Christine, Januel, Lionel, Calviere, Patrice, Menegon, François, Caparros, Fabrice, Bonneville, Thomas, Tourdias, Igor, Sibon, Gregory W, Albers, Christophe, Cognard, and Sylvain, Ledure
- Subjects
Stroke ,Treatment Outcome ,Endovascular Procedures ,Humans ,Surgery ,Arterial Occlusive Diseases ,Neurology (clinical) ,General Medicine ,Brain Ischemia ,Ischemic Stroke ,Retrospective Studies ,Thrombectomy - Abstract
BackgroundHalf of the patients with large vessel occlusion (LVO)-related acute ischemic stroke (AIS) who undergo endovascular reperfusion are dead or dependent at 3 months. We hypothesize that in addition to established prognostic factors, baseline imaging profile predicts outcome among reperfusers.MethodsConsecutive patients receiving endovascular treatment (EVT) within 6 hours after onset with Thrombolysis In Cerebral Infarction (TICI) 2b, 2c and 3 revascularization were included. Poor outcome was defined by a modified Rankin scale (mRS) 3–6 at 90 days. No mismatch (NoMM) profile was defined as a mismatch (MM) ratio ≤1.2 and/or a volume Results187 patients were included, and 81 (43%) had a poor outcome. Median delay from stroke onset to the end of EVT was 259 min (IQR 209–340). After multivariable logistic regression analysis, older age (OR 1.26, 95% CI 1.06 to 1.5; p=0.01), higher National Institutes of Health Stroke Scale (NIHSS) (OR 1.15, 95% CI 1.06 to 1.25; pConclusionsThe absence of a penumbra defined by a NoMM profile on baseline imaging appears to be an independent predictor of poor outcome after reperfusion. Strategies aiming to preserve the penumbra may be encouraged to improve these patients’ outcomes.
- Published
- 2021