PT  - JOURNAL ARTICLE
AU  - Uchida, Kazutaka
AU  - Yamagami, Hiroshi
AU  - Sakai, Nobuyuki
AU  - Shirakawa, Manabu
AU  - Beppu, Mikiya
AU  - Toyoda, Kazunori
AU  - Matsumaru, Yuji
AU  - Matsumoto, Yasushi
AU  - Todo, Kenichi
AU  - Hayakawa, Mikito
AU  - Shindo, Seigo
AU  - Ota, Shinzo
AU  - Morimoto, Masafumi
AU  - Takeuchi, Masataka
AU  - Imamura, Hirotoshi
AU  - Ikeda, Hiroyuki
AU  - Tanaka, Kanta
AU  - Ishihara, Hideyuki
AU  - Kakita, Hiroto
AU  - Sano, Takanori
AU  - Araki, Hayato
AU  - Nomura, Tatsufumi
AU  - Sakakibara, Fumihiro
AU  - Yoshimura, Shinichi
TI  - Endovascular therapy for acute intracranial large vessel occlusion due to atherothrombosis: Multicenter historical registry
AID  - 10.1136/jnis-2023-020670
DP  - 2023 Aug 30
TA  - Journal of NeuroInterventional Surgery
PG  - jnis-2023-020670
4099  - http://jnis.bmj.com/content/early/2023/08/30/jnis-2023-020670.short
4100  - http://jnis.bmj.com/content/early/2023/08/30/jnis-2023-020670.full
AB  - Background Atherothrombotic stroke-related large vessel occlusion (AT-LVO) is caused by two etiologies, the intracranial artery occlusion due to in situ occlusion (intracranial group) or due to embolism from cervical carotid occlusion or stenosis (tandem group). The prognosis and reocclusion rate of each etiology after endovascular therapy (EVT) is unclear.Methods We conducted a historical multicenter registry study at 51 Japanese centers to compare the prognoses of AT-LVO between two etiologies. The primary outcome was the incidence of recurrent ischemic stroke or reocclusion of the treated vessels within 90 days after EVT. Each of the primary outcome means the incidence of recurrent ischemic stroke and reocclusion of the treated vessels within 90 days after EVT.Results We analyzed 582 patients (338 in the intracranial group and 244 in the tandem group). Patients in the intracranial group were younger (mean 71.9 vs 74.5, p=0.003), more of them were female and fewer of them were current smokers than those in the tandem group. In the tandem group, the patients’ National Institutes of Health Stroke Scale score on admission was higher (13 vs 15, p=0.006), onset to puncture time was shorter (299 [145–631] vs 232 [144–459] minutes, p=0.03) and Alberta Stroke Program Early CT Score (ASPECTS) was lower (8 [7–9] vs 8 [6–9], p=0.0002). The primary outcome was higher in the intracranial group (22.5% vs 8.2%, p<0.0001). However, any ICH and death were not significantly different in the two groups.Conclusions The incidence of recurrent ischemic stroke or reocclusion after EVT for AT-LVO was higher in the intracranial group.Data are available upon reasonable request.