RT Journal Article
SR Electronic
T1 Early recanalization in large-vessel occlusion stroke patients transferred for endovascular treatment
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 480
OP 484
DO 10.1136/neurintsurg-2021-017441
VO 14
IS 5
A1 Nerea Arrarte Terreros
A1 Agnetha A E Bruggeman
A1 Isabella S J Swijnenburg
A1 Laura C C van Meenen
A1 Adrien E Groot
A1 Jonathan M Coutinho
A1 Yvo B W E M Roos
A1 Bart J Emmer
A1 Ludo F M Beenen
A1 Ed van Bavel
A1 Henk A Marquering
A1 Charles B L M Majoie
YR 2022
UL http://jnis.bmj.com/content/14/5/480.abstract
AB Background We performed an exploratory analysis to identify patient and thrombus characteristics associated with early recanalization in large-vessel occlusion (LVO) stroke patients transferred for endovascular treatment (EVT) from a primary (PSC) to a comprehensive stroke center (CSC).Methods We included patients with an LVO stroke of the anterior circulation who were transferred to our hospital for EVT and underwent repeated imaging between January 2016 and June 2019. We compared patient characteristics, workflow time metrics, functional outcome (modified Rankin Scale at 90 days), and baseline thrombus imaging characteristics, which included: occlusion location, thrombus length, attenuation, perviousness, distance from terminus of intracranial carotid artery to the thrombus (DT), and clot burden score (CBS), between early-recanalized LVO (ER-LVO), and non-early-recanalized LVO (NER-LVO) patients.Results One hundred and forty-nine patients were included in the analysis. Early recanalization occurred in 32% of patients. ER-LVO patients less often had a medical history of hypertension (31% vs 49%, P=0.04), and more often had clinical improvement between PSC and CSC (ΔNIHSS −5 vs 3, P<0.01), compared with NER-LVO patients. Thrombolysis administration was similar in both groups (88% vs 78%, P=0.18). ER-LVO patients had no ICA occlusions (0% vs 27%, P<0.01), more often an M2 occlusion (35% vs 17%, P=0.01), longer DT (27 mm vs 12 mm, P<0.01), shorter thrombi (17 mm vs 27 mm, P<0.01), and higher CBS (8 vs 6, P<0.01) at baseline imaging. ER-LVO patients had lower mRS scores (1 vs 3, P=0.02).Conclusions Early recanalization is associated with clinical improvement between PSC and CSC admission, more distal occlusions and shorter thrombi at baseline imaging, and better functional outcome.All data relevant to the study are included in the article or uploaded as supplementary information. The data that support the findings of this study are available upon reasonable request, after clearance by the local ethics committee.