Article Text

other Versions

PDF
Original research
Clinical outcomes of patients with acute minor stroke receiving rescue IA therapy following early neurological deterioration
  1. Joon-Tae Kim1,
  2. Suk-Hee Heo2,
  3. Woong Yoon3,
  4. Kang-Ho Choi1,
  5. Man-Seok Park1,
  6. Jeffrey L Saver4,
  7. Ki-Hyun Cho1
  1. 1Department of Neurololgy, Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea
  2. 2Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea
  3. 3Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
  4. 4Department of Neurology, Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA
  1. Correspondence to Dr Joon-Tae Kim, Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-ku, Gwangju 501-757, Korea; alldelight2{at}jnu.ac.kr

Abstract

Background Patients presenting with minor ischemic stroke frequently have early neurological deterioration (END) and poor final outcome. The optimal management of patients with END has not been determined.

Objective To investigate rescue IA therapy (IAT) when patients with acute minor ischemic stroke develop END.

Methods This was a retrospective study of consecutively registered patients with acute minor stroke and END. ‘END’ was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) scores by 1 or more points (or development of new neurological symptoms) and ‘ΔEND−NIHSS’ was defined as numerical difference between NIHSS scores at the time of END and before END. Rescue IAT following END was adjusted for the covariates to evaluate the association between IAT and favorable outcome at 3 months.

Results Among 982 patients with acute minor ischemic stroke, END occurred in 232 (23.6%). Of the 209 patients with END with full data available, 87 (41.6%) had favorable outcomes at 3 months. Rescue IAT following END was performed in 28 (13.4%). Favorable 3-month outcomes were seen in 50% of patients undergoing rescue IAT, including 8/19 (42.1%) undergoing rescue IAT beyond 8 h. By multivariate logistic regression analysis, rescue IAT following END was independently associated with favorable outcome at 3 months (OR=10.9; 95% CI 3.06 to 38.84; p<0.001).

Conclusions The results suggest that rescue IAT may be safe and effective when END occurs in selected patients with acute minor ischemic stroke. Further prospective and randomized studies are needed to confirm our results.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.