Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study
Language English Country United States Media print-electronic
Document type Multicenter Study, Journal Article
Grant support
IGA-KZ-2021-1-15
Krajska Zdravotni
IGA UPOL_009_2023
Univerzita Palackého v Olomouci
PubMed
38216741
PubMed Central
PMC10844141
DOI
10.1007/s00270-023-03649-x
PII: 10.1007/s00270-023-03649-x
Knihovny.cz E-resources
- Keywords
- Acute ischemic stroke, Clinical outcome, Endovascular treatment, Tandem lesion,
- MeSH
- Stroke * diagnostic imaging therapy etiology MeSH
- Endovascular Procedures * methods MeSH
- Ischemic Stroke * diagnostic imaging surgery MeSH
- Brain Ischemia * diagnostic imaging therapy etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors * MeSH
- Thrombectomy methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Names of Substances
- Hydroxymethylglutaryl-CoA Reductase Inhibitors * MeSH
PURPOSE: Endovascular treatment (EVT) of tandem lesion (TL) in anterior circulation (AC) acute ischemic stroke (AIS) represents still a clinical challenge. We aimed to evaluate selected factors related to EVT and assess other possible predictors of good clinical outcome besides the generally known ones. METHODS: AIS patients with TL in AC treated with EVT were enrolled in the multicenter retrospective ASCENT study. A good three-month clinical outcome was scored as 0-2 points in modified Rankin Scale (mRS) and achieved recanalization using the TICI scale. Symptomatic intracerebral hemorrhage (SICH) was assessed using the SITS-MOST criteria. Logistic regression analysis was used for the assessment of possible predictors of mRS 0-2 with adjustment for potential confounders. RESULTS: In total, 300 (68.7% males, mean age 67.3 ± 10.2 years) patients with median of admission NIHSS 17 were analyzed. Recanalization (TICI 2b-3) was achieved in 290 (96.7%) patients and 176 (58.7%) had mRS 0-2. Besides the age, admission NIHSS and SICH, admission glycemia (p = 0.005, OR: 0.884) the stent patency within the first 30 days after EVT (p = 0.0003, OR: 0.219), dual antiplatelet therapy (DAPT) started within 12 h after EVT (p < 0.0001, OR: 5.006) and statin therapy started within 24 h after stenting (p < 0.0001, OR: 5.558) were found as other predictors. CONCLUSION: Admission glycemia, start of DAPT within 12 h and statin therapy within 24 h after EVT, and stent patency within the first 30 days after EVT were found as other predictors of good three-month clinical outcome in AIS patients treated with EVT for TL.
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