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@ARTICLE{Maus:834700,
author = {Maus, Volker and You, Seunghwa and Kalkan, Alev and
Borggrefe, Jan and Kabbasch, Christoph and Barnikol, Utako
Birgit and Stetefeld, Henning and Dohmen, Christian and
Liebig, Thomas and Fink, Gereon Rudolf and Mpotsaris,
Anastasios},
title = {{I}ncomplete {L}arge {V}essel {O}cclusions in {M}echanical
{T}hrombectomy: {A}n {I}ndependent {P}redictor of
{F}avorable {O}utcome in {I}schemic {S}troke},
journal = {Cerebrovascular diseases},
volume = {44},
number = {3-4},
issn = {1421-9786},
address = {Basel},
publisher = {Karger},
reportid = {FZJ-2017-04603},
pages = {113 - 121},
year = {2017},
abstract = {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.},
cin = {INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-3-20090406},
pnm = {572 - (Dys-)function and Plasticity (POF3-572)},
pid = {G:(DE-HGF)POF3-572},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:28605743},
UT = {WOS:000417567200004},
doi = {10.1159/000477499},
url = {https://juser.fz-juelich.de/record/834700},
}