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Ischemic Stroke
Original research
Leukoaraiosis severity and outcomes after mechanical thrombectomy with stent-retriever devices in acute ischemic stroke
  1. Yongtao Guo1,2,
  2. Wenjie Zi1,
  3. Yue Wan3,
  4. Shuai Zhang1,4,
  5. Bo Sun1,2,
  6. Xianjin Shang1,5,
  7. Shun Li6,
  8. Yongjie Bai1,7,
  9. Zibao Li1,5,
  10. Dequan Zheng8,
  11. Xinfeng Liu1,6
  1. 1 Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing, China
  2. 2 Department of Neurology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Nanjing Medical University, Huaian, China
  3. 3 Department of Neurology, Hubei Zhongshan Hospital, Wuhan, China
  4. 4 Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
  5. 5 Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, China
  6. 6 Department of Neurology, Jinling Hospital, Southern Medical University, Jiangsu, China
  7. 7 Department of Neurology, First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
  8. 8 Department of Neurology, The 175th Hospital of The People’s Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Fujian, China
  1. Correspondence to Dr Yongtao Guo and Dr Xinfeng Liu, Department of Neurology, Jinling Hospital, Jinling Clinical College of Nanjing Medical University, Nanjing 210002, Jiangsu,China; gytu571{at}163.com, xfliu2{at}vip.163.com

Abstract

Background and purpose The aim of the study was to evaluate whether leukoaraiosis severity is associated with outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.

Methods In this retrospective multicenter study, we evaluated 251 acute stroke patients (pretreatment National Institutes of Health Stroke Scale score ≥8) treated with stent-retriever devices. Leukoaraiosis severity was graded as 0–2 (absent-to-moderate) versus 3–4 (severe) according to the van Swieten scale. The main clinical outcome was the proportion of good functional outcome, defined as a modified Rankin Scale of 0–2 at 90 days.

Results Significantly fewer patients in the severe LA group than in the absent-to-moderate LA group achieved a good functional outcome (18.4% vs 50.2%, P<0.001). In multivariable analysis, severe leukoaraiosis was a significant negative predictor of good functional outcome at 90 days (OR, 0.27; 95% CI 0.10–0.77; P=0.014).

Conclusions The severity of leukoaraiosis is independently associated with 90-day functional outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.

  • stroke
  • thrombectomy
  • leukoaraiosis

https://doi.org/10.1136/neurintsurg-2018-014018

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    Footnotes

    • YG and WZ contributed equally.

    • Contributors YG, YW, WZ: study design, primary manuscript writing, tables, and figure. YG, WZ, SZ: data acquisition and image analysis. BS, XS, SL, YB, ZL, DZ: data acquisition. WZ, XL: critical revision and final approval of the manuscript.

    • Funding This work was partly supported by National Natural Science Foundation of China grant number 81530038 and 81501193, Natural Science Foundation of Jiangsu Province grant number BE2016748, and National Key Research and Development Program grant number 2017YFC1307901.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Ethics committee of each participating center.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Additional material is published online only.