Outcome of a Real-World Cohort of Patients Subjected to Endovascular Treatment for Acute Ischemic Stroke.


Journal

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633

Informations de publication

Date de publication:
Jul 2022
Historique:
received: 29 11 2021
revised: 04 04 2022
accepted: 08 04 2022
pubmed: 29 4 2022
medline: 25 5 2022
entrez: 28 4 2022
Statut: ppublish

Résumé

Ischemic stroke is a leading cause of death and disability worldwide. For patients with large vessel occlusion stroke, endovascular treatment is now the most effective treatment. We aimed to assess the outcome of patients undergoing endovascular treatment for large vessel occlusion stroke in a real-world setting, comparing our results with data from randomized clinical trials, and recognizing the factors associated with prognosis. We retrospectively collected data on endovascular procedures performed in one comprehensive stroke center in consecutive patients presenting with large vessel occlusion stroke from January 2017 to January 2020. Data on baseline clinical, imaging, and treatment-related characteristics were recorded. Selection of patients and treatment approach was not standardized but followed current guidelines for ischemic stroke. Functional outcome was evaluated 3 months after endovascular treatment. Clinical, imaging and treatment-related variables associated to outcome were evaluated with univariate and multivariable analyses. Four hundred twelve patients were included in our study. Three-month functional independence was achieved in 50.5% of patients (50.3% in the anterior stroke and 52.1% in the posterior stroke subgroup). Successful arterial reperfusion was observed in 84.3% of patients. Age (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20-0.87, p = 0.020]), severe stroke at onset (OR 0.40, 95%CI 0.19-0.83), procedure related complications (OR 0.45, 95%CI 0.20-0.99), and good collateral circulation (OR 2.69, 95%CI 1.17-6.16) were associated with 3-month functional independence in multivariable model. Our real-world outcome results are in line with data from large randomized clinical trials on endovascular treatment for large vessel occlusion stroke.

Identifiants

pubmed: 35483241
pii: S1052-3057(22)00205-1
doi: 10.1016/j.jstrokecerebrovasdis.2022.106511
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106511

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Giuseppe Scopelliti (G)

''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, Milan, Milano 20157, Italy.

Guglielmo Pero (G)

Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy.

Antonio Macera (A)

Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy.

Luca Quilici (L)

Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy.

Amedeo Cervo (A)

Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy.

Giulia Platania (G)

Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza, 28, Milan, Milano 20122, Italy.

Carlo Sebastiano Tadeo (CS)

Neurology Unit, Istituto Clinico Città Studi, Via Jommelli 17, Milan, Milano 20131, Italy.

Alessandro Cesare Prelle (AC)

Neurology Unit, ASST Ovest Milanese, Via Papa Giovanni Paolo II C.P. 3, Legnano 20025, Italy.

Francesco Muscia (F)

Neurology Unit, ASST Ovest Milanese, Via Papa Giovanni Paolo II C.P. 3, Legnano 20025, Italy.

Maria Grazia Riggio (MG)

Neurology Unit, ASST Rhodense, V.le Forlanini, 95, Garbagnate Milanese 20024, Italy.

Angelo Zilioli (A)

Neurology Unit, Ospedale Maggiore di Lodi, Piazza Ospitale, 10, Lodi 26900, Italy.

Elio Clemente Agostoni (EC)

Department of Neuroscience, Neurology and Stroke Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy.

Mariangela Piano (M)

Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan, Milano 20162, Italy.

Leonardo Pantoni (L)

''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, Milan, Milano 20157, Italy. Electronic address: leonardo.pantoni@unimi.it.

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Classifications MeSH