Article ; Online: Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study.
Cardiovascular and interventional radiology
2024 Volume 47, Issue 2, Page(s) 218–224
Abstract: 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 ...
| Abstract | 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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| MeSH term(s) | Aged ; Female ; Humans ; Male ; Middle Aged ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/therapy ; Brain Ischemia/etiology ; Endovascular Procedures/methods ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/surgery ; Retrospective Studies ; Stroke/diagnostic imaging ; Stroke/therapy ; Stroke/etiology ; Thrombectomy/methods ; Treatment Outcome |
| Chemical Substances | Hydroxymethylglutaryl-CoA Reductase Inhibitors |
| Language | English |
| Publishing date | 2024-01-12 |
| Publishing country | United States |
| Document type | Multicenter Study ; Journal Article |
| ZDB-ID | 603082-8 |
| ISSN | 1432-086X ; 0342-7196 ; 0174-1551 |
| ISSN (online) | 1432-086X |
| ISSN | 0342-7196 ; 0174-1551 |
| DOI | 10.1007/s00270-023-03649-x |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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