1. Identifying large ischemic core volume ranges in acute stroke that can benefit from mechanical thrombectomy
- Author
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Takeshi Yoshimoto, Kanta Tanaka, Masayuki Shiozawa, Tetsu Satow, Junpei Koge, Kazunori Toyoda, Jun Takahashi, Masafumi Ihara, Kodai Kanemaru, Shunsuke Kimura, Masatoshi Koga, Manabu Inoue, Tetsuya Chiba, and Naruhiko Kamogawa
- Subjects
medicine.medical_specialty ,030204 cardiovascular system & hematology ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Modified Rankin Scale ,Internal medicine ,medicine ,Humans ,Stroke ,intervention ,Ischemic Stroke ,Retrospective Studies ,Thrombectomy ,Acute stroke ,Aged, 80 and over ,Core (anatomy) ,Medical treatment ,business.industry ,General Medicine ,medicine.disease ,stroke ,Mechanical thrombectomy ,Treatment Outcome ,standards ,Cardiology ,Female ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,MRI ,Volume (compression) - Abstract
BackgroundWe aimed to identify the large ischemic core (LIC) volume ranges in acute ischemic stroke patients that can benefit from mechanical thrombectomy (MT).MethodsConsecutive patients within 24 hours of onset of anterior circulation ischemic stroke with large vessel occlusion and ischemic core volumes of 70–300 mL were included from our single-center prospective database from March 2014 to December 2019. Subjects were divided into three groups by baseline ischemic core volume (A: 70–100 mL; B: 101–130 mL; C: >130 mL). We compared modified Rankin Scale (mRS) score 0–2 at 3 months and parenchymal hematoma between patients receiving MT and standard medical treatment (SMT), and determined clinically treatable core volume ranges for MT.ResultsOf 157 patients (86 women; median age, 81 years; median ischemic core volume, 123 mL), 49 patients underwent MT. In Group A (n=52), MT patients (n=31) showed a higher proportion of mRS 0–2 at 3 months (52% vs 5%, PConclusionsIschemic core volumes between 70 and 100 mL may benefit from MT. The treatable upper core limit is approximately 120 mL in selected patients with LIC of 70–300 mL.
- Published
- 2020