TY  - JOUR
AU  - Maus, Volker
AU  - You, Seunghwa
AU  - Kalkan, Alev
AU  - Borggrefe, Jan
AU  - Kabbasch, Christoph
AU  - Barnikol, Utako Birgit
AU  - Stetefeld, Henning
AU  - Dohmen, Christian
AU  - Liebig, Thomas
AU  - Fink, Gereon Rudolf
AU  - Mpotsaris, Anastasios
TI  - Incomplete Large Vessel Occlusions in Mechanical Thrombectomy: An Independent Predictor of Favorable Outcome in Ischemic Stroke
JO  - Cerebrovascular diseases
VL  - 44
IS  - 3-4
SN  - 1421-9786
CY  - Basel
PB  - Karger
M1  - FZJ-2017-04603
SP  - 113 - 121
PY  - 2017
AB  - Background and Purpose: Cerebral large vessel occlusion (LVO) in acute ischemic stroke (AIS) may be complete (CLVO) or incomplete (ILVO). The influence of ILVO on clinical outcome after mechanical thrombectomy (MT) remains unclear. We investigated primarily the clinical outcome in patients with AIS due to ILVO or CLVO. Methods: Five hundred three consecutive AIS patients with LVO treated with stent-retriever or direct aspiration-based MT between 2010 and 2016 were analyzed. The primary endpoint was favorable clinical outcome (modified Rankin Scale ≤2) at 90 days; secondary endpoints were periprocedural parameters. Results: Forty-nine patients (11.3%) with a median National Institutes of Health Stroke Scale (NIHSS) of 11 presented with ILVO and the remainder presented with CLVO and median NIHSS of 15 (p < 0.001). The median groin puncture-to-reperfusion time was 30 vs. 67 min, respectively (p < 0.001). Successful reperfusion was reached in 47 out of 49 ILVO (95.9%) vs. 298 out of 381 CLVO (78.2%; p < 0.005) with less retrieval maneuvers (1.7 ± 2.2 vs. 3.0 ± 2.5; p < 0.001). The favorable outcome at 90 days was 81% in patients with ILVO vs. 29.1% in CLVO (p < 0.001); respective all-cause mortality rates were 6.4 vs. 28.5% (p < 0.001). Periprocedural complications (6.9%) occurred exclusively in CLVO patients (p < 0.05). ILVO was associated with favorable clinical outcome independent of age and NIHSS in multivariate logistic regression both in the anterior (OR 3.6; 95% CI 1.8-6.9; p < 0.001) and posterior circulation (OR 3.5; 95% CI 1.8-6.9; p < 0.001). Conclusions: AIS due to ILVO is frequent and is associated with a nearly threefold higher chance of favorable clinical outcome at 90 days, independent of age and initial NIHSS compared to CLVO.
LB  - PUB:(DE-HGF)16
C6  - pmid:28605743
UR  - <Go to ISI:>//WOS:000417567200004
DO  - DOI:10.1159/000477499
UR  - https://juser.fz-juelich.de/record/834700
ER  -