Influence of time to endovascular stroke treatment on outcomes in the early versus extended window paradigms.
Thrombectomy
ischemic stroke
registry
stroke
time
treatment
Journal
International journal of stroke : official journal of the International Stroke Society
ISSN: 1747-4949
Titre abrégé: Int J Stroke
Pays: United States
ID NLM: 101274068
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
pubmed:
17
3
2021
medline:
23
3
2022
entrez:
16
3
2021
Statut:
ppublish
Résumé
The effect of time from stroke onset to thrombectomy in the extended time window remains poorly characterized. We aimed to analyze the relationship between time to treatment and clinical outcomes in the early versus extended time windows. Proximal anterior circulation occlusion patients from a multicentric prospective registry were categorized into early (≤6 h) or extended (>6-24 h) treatment window. Patients with baseline National Institutes of Health Stroke Scale (NIHSS) ≥ 10 and intracranial internal carotid artery or middle cerebral artery-M1-segment occlusion and pre-morbid modified Rankin scale (mRS) 0-1 ("DAWN-like" cohort) served as the population for the primary analysis. The relationship between time to treatment and 90-day mRS, analyzed in ordinal (mRS shift) and dichotomized (good outcome, mRS 0-2) fashion, was compared within and across the extended and early windows. A total of 1603 out of 2008 patients qualified. Despite longer time to treatment (9[7-13.9] vs. 3.4[2.5-4.3] h, The impact of time to thrombectomy on outcomes appears to be time dependent with a steep influence in the early followed by a less significant plateau in the extended window. However, every effort should be made to shorten treatment times regardless of ischemia duration.
Sections du résumé
BACKGROUND
BACKGROUND
The effect of time from stroke onset to thrombectomy in the extended time window remains poorly characterized.
AIM
OBJECTIVE
We aimed to analyze the relationship between time to treatment and clinical outcomes in the early versus extended time windows.
METHODS
METHODS
Proximal anterior circulation occlusion patients from a multicentric prospective registry were categorized into early (≤6 h) or extended (>6-24 h) treatment window. Patients with baseline National Institutes of Health Stroke Scale (NIHSS) ≥ 10 and intracranial internal carotid artery or middle cerebral artery-M1-segment occlusion and pre-morbid modified Rankin scale (mRS) 0-1 ("DAWN-like" cohort) served as the population for the primary analysis. The relationship between time to treatment and 90-day mRS, analyzed in ordinal (mRS shift) and dichotomized (good outcome, mRS 0-2) fashion, was compared within and across the extended and early windows.
RESULTS
RESULTS
A total of 1603 out of 2008 patients qualified. Despite longer time to treatment (9[7-13.9] vs. 3.4[2.5-4.3] h,
CONCLUSIONS
CONCLUSIONS
The impact of time to thrombectomy on outcomes appears to be time dependent with a steep influence in the early followed by a less significant plateau in the extended window. However, every effort should be made to shorten treatment times regardless of ischemia duration.
Identifiants
pubmed: 33724080
doi: 10.1177/17474930211006304
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM