Journal article
Outcomes of mechanical thrombectomy in stroke patients with extreme large infarction core
Journal of neurointerventional surgery, Vol.16(12), pp.1268-1274
12/2024
DOI: 10.1136/jnis-2023-021046
PMID: 38041671
Abstract
BackgroundRecent clinical trials have demonstrated that patients with large vessel occlusion (LVO) and large infarction core may still benefit from mechanical thrombectomy (MT). In this study, we evaluate outcomes of MT in LVO patients presenting with extremely large infarction core Alberta Stroke Program Early CT Score (ASPECTS 0–2).MethodsData from the Stroke Thrombectomy and Aneurysm Registry (STAR) was interrogated. We identified thrombectomy patients presenting with an occlusion in the intracranial internal carotid artery (ICA) or M1 segment of the middle cerebral artery and extremely large infarction core (ASPECTS 0–2). A favorable outcome was defined by achieving a modified Rankin scale of 0–3 at 90 days post-MT. Successful recanalization was defined by achieving a modified Thrombolysis In Cerebral Ischemia (mTICI) score ≥2B.ResultsWe identified 58 patients who presented with ASPECTS 0–2 and underwent MT . Median age was 70.0 (59.0–78.0) years, 45.1% were females, and 202 (36.3%) patients received intravenous tissue plasminogen activator. There was no difference regarding the location of the occlusion (p=0.57). Aspiration thrombectomy was performed in 268 (54.6%) patients and stent retriever was used in 70 (14.3%) patients. In patients presenting with ASPECTS 0-2 the mortality rate was 4.5%, 27.9% had mRS 0-3 at day 90, 66.67% ≥70 years of age had mRS of 5-6 at day 90. On multivariable analysis, age, National Institutes of Health Stroke Scale on admission, and successful recanalization (mTICI ≥2B) were independently associated with favorable outcomes.ConclusionsThis multicentered, retrospective cohort study suggests that MT may be beneficial in a select group of patients with ASPECTS 0–2.
Details
- Title: Subtitle
- Outcomes of mechanical thrombectomy in stroke patients with extreme large infarction core
- Creators
- Eyad Almallouhi - Sarasota Memorial HospitalSara Zandpazandi - Medical University of South CarolinaMohammad Anadani - Medical University of South CarolinaConor Cunningham - Medical University of South CarolinaMohammad-Mahdi Sowlat - Medical University of South CarolinaHidetoshi Matsukawa - Medical University of South CarolinaAtakan Orscelik - Mayo ClinicSameh Elawady - Medical University of South CarolinaIlko MaierSami Al Kasab - Medical University of South CarolinaPascal Jabbour - Thomas Jefferson UniversityJoon-Tae KimStacey Wolfe - Wake Forest UniversityAnsaar Rai - West Virginia University HospitalsRobert Starke - University of MiamiMarios-Nikos PsychogiosEdgar Samaniego - University of IowaAdam Arthur - University of Tennessee Health Science CenterShinichi Yoshimura - Hyogo Medical UniversityHugo Cuellar - Louisiana State University Health Sciences Center ShreveportJonathan Grossberg - Emory UniversityAli Alawieh - Emory UniversityDaniele Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaOmar Tanweer - NYU Langone HealthJustin Mascitelli - The University of Texas Health Science Center at San AntonioIsabel Fragata - Unidade Local de Saúde de São JoséAdam Polifka - University of FloridaJoshua Osbun - Washington University in St. LouisRoberto CrosaCharles Matouk - Yale UniversityMin Park - University of VirginiaMichael Levitt - University of WashingtonWaleed Brinjikji - Mayo Clinic in ArizonaMark Moss - Washington Regional Medical CenterTravis Dumont - University of ArizonaRichard Williamson - Allegheny Health NetworkPedro Navia - Hospital Universitario La PazPeter Kan - The University of Texas Medical Branch at GalvestonReade De Leacy - Icahn School of Medicine at Mount SinaiShakeel Chowdhry - NorthShore University HealthSystemMohamad Ezzeldin - University of HoustonAlejandro Spiotta - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.16(12), pp.1268-1274
- DOI
- 10.1136/jnis-2023-021046
- PMID
- 38041671
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group LTD
- Language
- English
- Electronic publication date
- 11/01/2023
- Date published
- 12/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984516952002771
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