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Outcome of standard and high-risk patients with acute anterior circulation stroke after stent retriever thrombectomy.
- Source :
-
Stroke [Stroke] 2014 Jan; Vol. 45 (1), pp. 152-8. Date of Electronic Publication: 2013 Nov 21. - Publication Year :
- 2014
-
Abstract
- Background and Purpose: Stent retrievers have become an important tool for the treatment of acute ischemic stroke. The aim of this study was to analyze outcome and complications in a large cohort of patients with stroke treated with the Solitaire stent retriever. The study also included patients who did not meet standard inclusion criteria for endovascular treatment: low or high baseline National Institutes of Health Stroke Scale score, ≥80 years of age, extensive ischemic signs in middle cerebral artery territory, and time from symptom onset to endovascular intervention>8 hours.<br />Methods: Consecutive patients with acute anterior circulation stroke treated with the Solitaire FR were analyzed. Data on characteristics of endovascular interventions, complications, and clinical outcome were collected prospectively. Patients who met standard inclusion criteria were compared with those who did not.<br />Results: A total of 227 patients were included. Mean age was 68.2±14.7 years, and median National Institutes of Health Stroke Scale score on admission was 16 (range, 2-36). Reperfusion was successful (thrombolysis in cerebral infarction, 2b-3) in 70.9%. Outcome was favorable (modified Rankin Scale, 0-2) in 57.7% of patients who met standard inclusion criteria and 30.3% of those who did not. The rates for symptomatic intracranial hemorrhage were 3.7% and 13.1%, for death 11.4% and 33.8%, and for symptomatic intraprocedural complications 2.5% and 4.8%, respectively.<br />Conclusions: Patients<80 years of age, without extensive pretreatment ischemic signs, and baseline National Institutes of Health Stroke Scale score≤30 had high rates of favorable outcome and low periprocedural complication rates after Solitaire thrombectomy. Successful reperfusion was also common in patients not fulfilling standard inclusion criteria, but worse clinical outcomes warrant further research with a special focus on optimal patient selection.
- Subjects :
- Aged
Aged, 80 and over
Anesthesia, General
Cerebral Angiography
Cohort Studies
Endovascular Procedures
Female
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Middle Aged
Middle Cerebral Artery pathology
Patient Safety
Postoperative Complications epidemiology
Postoperative Complications therapy
Registries
Risk Factors
Thrombectomy adverse effects
Tomography, X-Ray Computed
Treatment Outcome
Stents
Stroke surgery
Thrombectomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 45
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 24262328
- Full Text :
- https://doi.org/10.1161/STROKEAHA.113.002591