1. Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real-world multicenter experience
- Author
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Yeo, Leonard Leong-Litt, Chen, Vanessa Hui En, Leow, Aloysius Sheng-Ting, Meyer, Lukas, Fiehler, Jens, Tu, Tian-Ming, Tham, Carol Huilian, Sia, Ching-Hui, Jamous, Ala, Behme, Daniel, Kastrup, Andreas, Papanagiotou, Panagiotis, Styczen, Hanna, Forsting, Michael, Lee, Tsong-Hai, Chu, Chan-Lin, Fischer, Sebastian, Maus, Volker, Abdullayev, Nuran, Kabbasch, Christoph, Moench, Sebastian, Maegerlein, Christian, Arnberg, Fabian, Andersson, Tommy, Holmin, Staffan, Teoh, Hock-Luen, Paliwal, Prakash, Ahmad, Aftab, Gopinathan, Anil, Yang, Cunli, Seet, Raymond Chee-Seong, Chan, Bernard Poon-Lap, Sharma, Vijay K., Tan, Benjamin Yong-Qiang, Yeo, Leonard Leong-Litt, Chen, Vanessa Hui En, Leow, Aloysius Sheng-Ting, Meyer, Lukas, Fiehler, Jens, Tu, Tian-Ming, Tham, Carol Huilian, Sia, Ching-Hui, Jamous, Ala, Behme, Daniel, Kastrup, Andreas, Papanagiotou, Panagiotis, Styczen, Hanna, Forsting, Michael, Lee, Tsong-Hai, Chu, Chan-Lin, Fischer, Sebastian, Maus, Volker, Abdullayev, Nuran, Kabbasch, Christoph, Moench, Sebastian, Maegerlein, Christian, Arnberg, Fabian, Andersson, Tommy, Holmin, Staffan, Teoh, Hock-Luen, Paliwal, Prakash, Ahmad, Aftab, Gopinathan, Anil, Yang, Cunli, Seet, Raymond Chee-Seong, Chan, Bernard Poon-Lap, Sharma, Vijay K., and Tan, Benjamin Yong-Qiang
- Abstract
Endovascular thrombectomy (EVT) is the standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO). Young patients with AIS-LVO have distinctly different underlying stroke mechanisms and etiologies. Much is unknown about the safety and efficacy of EVT in this population of young AIS-LVO patients. All consecutive AIS-LVO patients aged 50 years and below were included in this multicenter cohort study. The primary outcome measured was functional recovery at 90 days, with modified Rankin Scale of 0-2 deemed as good functional outcome. A total of 275 AIS-LVO patients that underwent EVT from 10 tertiary centers in Germany, Sweden, Singapore, and Taiwan were included. Successful reperfusion was achieved in 85.1% (234/275). Good functional outcomes were achieved in 66.0% (182/275). Arterial dissection was the most prevalent stroke etiology (42/195, 21.5%). National Institutes of Health Stroke Scale (NIHSS) score at presentation was inversely related to good functional outcomes (aOR: 0.92, 95% CI: 0.88-0.96 per point increase, p < 0.001). Successful reperfusion (aOR: 3.22, 95% CI: 1.44-7.21, p = 0.005), higher ASPECTS (aOR: 1.21, 95% CI: 1.01-1.44, p = 0.036), and bridging intravenous thrombolysis (aOR: 2.37, 95% CI: 1.29-4.34, p = 0.005) independently predicted good functional outcomes. Successful reperfusion was inversely associated with in-hospital mortality (aOR: 0.14, 95% CI: 0.03-0.57, p = 0.006). History of hypertension strongly predicted in-hospital mortality (aOR: 4.59, 95% CI: 1.10-19.13, p = 0.036). While differences in functional outcomes exist across varying stroke aetiologies, high rates of successful reperfusion and good outcomes are generally achieved in young AIS-LVO patients undergoing EVT.
- Published
- 2021