Predictors of unfavorable outcomes despite substantial reperfusion: Insights from Analysis of Revascularization in Ischemic Stroke With EmboTrap II Study.

Siddiqui, Adnan H; Waqas, Muhammad; Andersson, Tommy; Saver, Jeffrey L; Mattle, Heinrich P; Bozorgchami, Hormozd; Ribó, Marc; Zaidat, Osama O (2022). Predictors of unfavorable outcomes despite substantial reperfusion: Insights from Analysis of Revascularization in Ischemic Stroke With EmboTrap II Study. Interventional neuroradiology, 28(5), pp. 556-561. Sage Publications 10.1177/15910199211051553

Text Siddiqui__2021__Predictors_of_unfavorable_outcomes.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Author holds Copyright Download (596kB) | Request a copy

BACKGROUND

A considerable proportion of stroke patients have unfavorable outcomes despite substantial reperfusion during mechanical thrombectomy for large vessel occlusion. This study aimed to determine predictors of unfavorable outcomes despite substantial reperfusion (modified thrombolysis in cerebral infarction score of ≥2b).

METHODS

We conducted a post hoc analysis of Analysis of Revascularization in Ischemic Stroke With EmboTrap, a prospective, multicenter study on the efficacy of the EmboTrap revascularization device. We included patients with anterior large vessel occlusion, substantial reperfusion within three passes, and 3-month follow-up. Univariate and multivariate logistic regression analyses were performed to determine independent predictors of dependency or death (modified Rankin Score 3-6) at 90 days.

RESULTS

Of the 176 patients included in the study, 124 (70.45%) achieved modified Rankin Score of 0-2 at 90 days and 52 (29.6%) had modified Rankin Score of 3-6. On univariate analysis, patient age and initial National Institutes of Health Stroke Scale score were significantly higher in the modified Rankin Score of 3-6 groups (71.4 ± 11.3 years vs. 66.0 ± 13.1 years, 0.01; 18.9 ± 4.13 vs. 14.6 ± 4.36, p < 0.01, respectively). Mean number of passes and symptomatic intracranial hemorrhage were also higher in patients with modified Rankin Score of 3-6 (2.46 ± 1.42 vs. 1.65 ± 0.9, p < 0.01; 13.5% vs. 2.4%, p = 0.008). On multivariate analysis, initial National Institutes of Health Stroke Scale score and mean number of passes and were independent predictors of modified Rankin Score of 3-6 at 90 days.

CONCLUSION

More severe initial neurologic deficit and higher number of passes in patients with substantial reperfusion were independent predictors of dependency or death. These findings highlight a reduction in the number of passes required to achieve reperfusion as a therapeutic target to improve the outcome after thrombectomy.

Interest & Impact

Downloads

1 since deposited on 03 Dec 2021
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item