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  • 1
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    Association Between Intravenous Thrombolysis and Clinical Outcomes Among Patients With Ischemic Stroke and Unsuccessful Mechanical Reperfusion
    American Medical Association (AMA) ; 2023
    In:  JAMA Network Open Vol. 6, No. 5 ( 2023-05-01), p. e2310213-
    Details
    In: JAMA Network Open, American Medical Association (AMA), Vol. 6, No. 5 ( 2023-05-01), p. e2310213-
    Kurzfassung: Clinical evidence of the potential treatment benefit of intravenous thrombolysis preceding unsuccessful mechanical thrombectomy (MT) is scarce. Objective To determine whether intravenous thrombolysis (IVT) prior to unsuccessful MT improves functional outcomes in patients with acute ischemic stroke. Design, Setting, and Participants Patients were enrolled in this retrospective cohort study from the prospective, observational, multicenter German Stroke Registry–Endovascular Treatment between May 1, 2015, and December 31, 2021. This study compared IVT plus MT vs MT alone in patients with acute ischemic stroke due to anterior circulation large-vessel occlusion in whom mechanical reperfusion was unsuccessful. Unsuccessful mechanical reperfusion was defined as failed (final modified Thrombolysis in Cerebral Infarction grade of 0 or 1) or partial (grade 2a). Patients meeting the inclusion criteria were matched by treatment group using 1:1 propensity score matching. Interventions Mechanical thrombectomy with or without IVT. Main Outcomes and Measures Primary outcome was functional independence at 90 days, defined as a modified Rankin Scale score of 0 to 2. Safety outcomes were the occurrence of symptomatic intracranial hemorrhage and death. Results After matching, 746 patients were compared by treatment arms (median age, 78 [IQR, 68-84] years; 438 women [58.7%] ). The proportion of patients who were functionally independent at 90 days was 68 of 373 (18.2%) in the IVT plus MT and 42 of 373 (11.3%) in the MT alone group (adjusted odds ratio [AOR], 2.63 [95% CI, 1.41-5.11] ; P  = .003). There was a shift toward better functional outcomes on the modified Rankin Scale favoring IVT plus MT (adjusted common OR, 1.98 [95% CI, 1.35-2.92]; P   & amp;lt; .001). The treatment benefit of IVT was greater in patients with partial reperfusion compared with failed reperfusion. There was no difference in symptomatic intracranial hemorrhages between treatment groups (AOR, 0.71 [95% CI, 0.29-1.81]; P  = .45), while the death rate was lower after IVT plus MT (AOR, 0.54 [95% CI, 0.34-0.86]; P  = .01). Conclusions and Relevance These findings suggest that prior IVT was safe and improved functional outcomes at 90 days. Partial reperfusion was associated with a greater treatment benefit of IVT, indicating a positive interaction between IVT and MT. These results support current guidelines that all eligible patients with stroke should receive IVT before MT and add a new perspective to the debate on noninferiority of combined stroke treatment.
    Materialart: Online-Ressource
    ISSN: 2574-3805
    URL: Article
    DOI: 10.1001/jamanetworkopen.2023.10213
    Sprache: Englisch
    Verlag: American Medical Association (AMA)
    Publikationsdatum: 2023
    ZDB Id: 2931249-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Intravenous tPA (Tissue-Type Plasminogen Activator) Correlates With Favorable Venous Outflow Profiles in Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Stroke Vol. 53, No. 10 ( 2022-10), p. 3145-3152
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. 10 ( 2022-10), p. 3145-3152
    Kurzfassung: Intravenous tPA (tissue-type plasminogen activator) is often administered before endovascular thrombectomy (EVT). Recent studies have questioned whether tPA is necessary given the high rates of arterial recanalization achieved by EVT, but whether tPA impacts venous outflow (VO) is unknown. We investigated whether tPA improves VO profiles on baseline computed tomography (CT) angiography (CTA) images before EVT. Methods: Retrospective multicenter cohort study of patients with acute ischemic stroke due to large vessel occlusion undergoing EVT triage. Included patients underwent CT, CTA, and CT perfusion before EVT. VO profiles were determined by opacification of the vein of Labbé, sphenoparietal sinus, and superficial middle cerebral vein on CTA as 0, not visible; 1, moderate opacification; and 2, full. Pial arterial collaterals were graded on CTA, and tissue-level collaterals were assessed on CT perfusion using the hypoperfusion intensity ratio. Clinical and demographic data were determined from the electronic medical record. Using multivariable regression analysis, we determined the correlation between tPA administration and favorable VO profiles. Results: Seven hundred seventeen patients met inclusion criteria. Three hundred sixty-five patients received tPA (tPA+), while 352 patients were not treated with tPA (tPA−). Fewer tPA+ patients had atrial fibrillation (n=128 [35%] versus n=156 [44%] ; P =0.012) and anticoagulants/antiplatelet treatment before acute ischemic stroke due to large vessel occlusion onset (n=130 [36%] versus n=178 [52%] ; P 〈 0.001) compared with tPA− patients. One hundred eighty-five patients (51%) in the tPA+ and 100 patients (28%) in the tPA− group exhibited favorable VO ( P 〈 0.001). Multivariable regression analysis showed that tPA administration was a strong independent predictor of favorable VO profiles (OR, 2.6 [95% CI, 1.7–4.0]; P 〈 0.001) after control for favorable pial arterial CTA collaterals, favorable tissue-level collaterals on CT perfusion, age, presentation National Institutes of Health Stroke Scale, antiplatelet/anticoagulant treatment, history of atrial fibrillation and time from symptom onset to imaging. Conclusions: In patients with acute ischemic stroke due to large vessel occlusion undergoing thrombectomy triage, tPA administration was strongly associated with the presence of favorable VO profiles.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.122.038560
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2022
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    Distinct intra‐arterial clot localization affects tissue‐level collaterals and venous outflow profiles
    Wiley ; 2021
    In:  European Journal of Neurology Vol. 28, No. 12 ( 2021-12), p. 4109-4116
    Details
    In: European Journal of Neurology, Wiley, Vol. 28, No. 12 ( 2021-12), p. 4109-4116
    Kurzfassung: Arterial clot localization affects collateral flow to ischemic brain in patients with acute ischemic stroke due to large vessel occlusion (AIS‐LVO). We determined the association between vessel occlusion locations, tissue‐level collaterals (TLC), and venous outflow (VO) profiles and their impact on good functional outcomes. Methods We conducted a multicenter retrospective cohort study of consecutive AIS‐LVO patients who underwent thrombectomy triage. Baseline computed tomographic angiography (CTA) was used to localize vessel occlusion, which was dichotomized into proximal vessel occlusion (PVO; internal carotid artery and proximal first segment of the middle cerebral artery [M1]) and distal vessel occlusion (DVO; distal M1 and M2), and to assess collateral scores. TLC were assessed on computed tomographic perfusion data using the hypoperfusion intensity ratio. VO was determined on baseline CTA by the cortical vein opacification score. Primary outcomes were favorable VO and TLC; secondary outcome was the modified Rankin Scale after 90 days. Results A total of 649 patients met inclusion criteria. Of these, 376 patients (58%) had a PVO and 273 patients (42%) had a DVO. Multivariate ordinal logistic regression showed that DVO predicted favorable TLC (odds ratio [OR] = 1.77, 95% confidence interval [CI] = 1.24–2.52, p = 0.002) and favorable VO (OR = 7.2, 95% CI = 5.2–11.9, p 〈 0.001). DVO (OR = 3.4, 95% CI = 2.1–5.6, p 〈 0.001), favorable VO (OR = 6.4, 95% CI = 3.8–10.6, p 〈 0.001), and favorable TLC (OR = 3.2, 95% CI = 2–5.3, p 〈 0.001), but not CTA collaterals (OR = 1.07, 95% CI = 0.60–1.91, p = 0.813), were predictors of good functional outcome. Conclusions DVO in AIS‐LVO patients correlates with favorable TLC and VO profiles, which are associated with good functional outcome.
    Materialart: Online-Ressource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v28.12
    DOI: 10.1111/ene.15079
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2020241-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Cerebral Hypoperfusion Intensity Ratio Is Linked to Progressive Early Edema Formation
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 9 ( 2022-04-23), p. 2373-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 9 ( 2022-04-23), p. 2373-
    Kurzfassung: The hypoperfusion intensity ratio (HIR) is associated with collateral status and reflects the impaired microperfusion of brain tissue in patients with acute ischemic stroke and large vessel occlusion (AIS-LVO). As a deterioration in cerebral blood flow is associated with brain edema, we aimed to investigate whether HIR is correlated with the early edema progression rate (EPR) determined by the ischemic net water uptake (NWU) in a multicenter retrospective analysis of AIS-LVO patients anticipated for thrombectomy treatment. HIR was automatically calculated as the ratio of time-to-maximum (TMax) 〉 10 s/(TMax) 〉 6 s. HIRs 〈 0.4 were regarded as favorable (HIR+) and ≥0.4 as unfavorable (HIR−). Quantitative ischemic lesion NWU was delineated on baseline NCCT images and EPR was calculated as the ratio of NWU/time from symptom onset to imaging. Multivariable regression analysis was used to assess the association of HIR with EPR. This study included 731 patients. HIR+ patients exhibited a reduced median NWU upon admission CT (4% (IQR: 2.1–7.6) versus 8.2% (6–10.4); p 〈 0.001) and less median EPR (0.016%/h (IQR: 0.007–0.04) versus 0.044%/h (IQR: 0.021–0.089; p 〈 0.001) compared to HIR− patients. Multivariable regression showed that HIR+ (β: 0.53, SE: 0.02; p = 0.003) and presentation of the National Institutes of Health Stroke Scale (β: 0.2, SE: 0.0006; p = 0.001) were independently associated with EPR. In conclusion, favorable HIR was associated with lower early edema progression and decreased ischemic edema formation on baseline NCCT.
    Materialart: Online-Ressource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11092373
    Sprache: Englisch
    Verlag: MDPI AG
    Publikationsdatum: 2022
    ZDB Id: 2662592-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Venous Outflow Profiles Are Linked to Cerebral Edema Formation at Noncontrast Head CT after Treatment in Acute Ischemic Stroke Regardless of Collateral Vessel Status at CT Angiography
    Radiological Society of North America (RSNA) ; 2021
    In:  Radiology Vol. 299, No. 3 ( 2021-06), p. 682-690
    Details
    In: Radiology, Radiological Society of North America (RSNA), Vol. 299, No. 3 ( 2021-06), p. 682-690
    Materialart: Online-Ressource
    ISSN: 0033-8419 , 1527-1315
    URL: Article
    DOI: 10.1148/radiol.2021203651
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Radiological Society of North America (RSNA)
    Publikationsdatum: 2021
    ZDB Id: 80324-8
    ZDB Id: 2010588-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Perfusion Imaging Predicts Favorable Outcomes after Basilar Artery Thrombectomy
    Wiley ; 2022
    In:  Annals of Neurology Vol. 91, No. 1 ( 2022-01), p. 23-32
    Details
    In: Annals of Neurology, Wiley, Vol. 91, No. 1 ( 2022-01), p. 23-32
    Kurzfassung: Perfusion imaging identifies anterior circulation stroke patients who respond favorably to endovascular thrombectomy (ET), but its role in basilar artery occlusion (BAO) is unknown. We hypothesized that BAO patients with limited regions of severe hypoperfusion (time to reach maximum concentration in seconds [Tmax] 〉  10) would have a favorable response to ET compared to patients with more extensive regions involved. Methods We performed a multicenter retrospective cohort study of BAO patients with perfusion imaging prior to ET. We prespecified a Critical Area Perfusion Score (CAPS; 0–6 points), which quantified severe hypoperfusion (Tmax 〉  10) in cerebellum (1 point/hemisphere), pons (2 points), and midbrain and/or thalamus (2 points). Patients were dichotomized into favorable (CAPS ≤ 3) and unfavorable (CAPS  〉  3) groups. The primary outcome was a favorable functional outcome 90 days after ET (modified Rankin Scale = 0–3). Results One hundred three patients were included. CAPS ≤ 3 patients (87%) had a lower median National Institutes of Health Stroke Scale score (NIHSS; 12.5, interquartile range [IQR] = 7–22) compared to CAPS 〉  3 patients (13%; 23, IQR = 19–36; p  = 0.01). Reperfusion was achieved in 84% of all patients, with no difference between CAPS groups ( p  = 0.42). Sixty‐four percent of reperfused CAPS ≤ 3 patients had a favorable outcome compared to 8% of nonreperfused CAPS ≤ 3 patients (odds ratio [OR] = 21.0, 95% confidence interval [CI] = 2.6–170; p   〈  0.001). No CAPS  〉  3 patients had a favorable outcome, regardless of reperfusion. In a multivariate regression analysis, CAPS ≤ 3 was a robust independent predictor of favorable outcome after adjustment for reperfusion, age, and pre‐ET NIHSS (OR = 39.25, 95% CI = 1.34– 〉 999, p  = 0.04). Interpretation BAO patients with limited regions of severe hypoperfusion had a favorable response to reperfusion following ET. However, patients with more extensive regions of hypoperfusion in critical brain regions did not benefit from endovascular reperfusion. ANN NEUROL 2022;91:23–32
    Materialart: Online-Ressource
    ISSN: 0364-5134 , 1531-8249
    URL: Issue
    URL: Article
    DOI: 10.1002/ana.v91.1
    DOI: 10.1002/ana.26272
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2022
    ZDB Id: 2037912-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    Venous Outflow Profiles Are Linked to Clinical Outcomes in Ischemic Stroke Patients with Extensive Baseline Infarct
    Korean Stroke Society ; 2022
    In:  Journal of Stroke Vol. 24, No. 3 ( 2022-09-30), p. 372-382
    Details
    In: Journal of Stroke, Korean Stroke Society, Vol. 24, No. 3 ( 2022-09-30), p. 372-382
    Kurzfassung: Background and Purpose The benefit of endovascular thrombectomy (EVT) treatment is still unclear in stroke patients presenting with extensive baseline infarct. The use of additional imaging biomarkers could improve clinical outcome prediction and individualized EVT selection in this vulnerable cohort. We hypothesized that cerebral venous outflow (VO) may be associated with functional outcomes in patients with low Alberta Stroke Program Early CT Score (ASPECTS).Methods We conducted a retrospective multicenter cohort study of patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). Extensive baseline infarct was defined by an ASPECTS of ≤5 on admission computed tomography (CT). VO profiles were assessed on admission CT angiography using the Cortical Vein Opacification Score (COVES). Favorable VO was defined as COVES ≥3. Multivariable logistic regression was used to determine the association between cerebral VO and good clinical outcomes (90-day modified Rankin Scale score of ≤3).Results A total of 98 patients met the inclusion criteria. Patients with extensive baseline infarct and favorable VO achieved significantly more often good clinical outcomes compared to patients with unfavorable VO (45.5% vs. 10.5%, P 〈 0.001). Higher COVES were strongly associated with good clinical outcomes (odds ratio, 2.17; 95% confidence interval, 1.15 to 4.57; P=0.024), independent of ASPECTS, National Institutes of Health Stroke Scale, and success of EVT.Conclusions Cerebral VO profiles are associated with good clinical outcomes in AIS-LVO patients with extensive baseline infarct. VO profiles could serve as a useful additional imaging biomarker for treatment selection and outcome prediction in low ASPECTS patients.
    Materialart: Online-Ressource
    ISSN: 2287-6391 , 2287-6405
    URL: Article
    DOI: 10.5853/jos.2022.01046
    Sprache: Englisch
    Verlag: Korean Stroke Society
    Publikationsdatum: 2022
    ZDB Id: 2814366-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Hypoperfusion Intensity Ratio Is Correlated With the Risk of Parenchymal Hematoma After Endovascular Stroke Treatment
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke Vol. 54, No. 1 ( 2023-01), p. 135-143
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. 1 ( 2023-01), p. 135-143
    Kurzfassung: Parenchymal hematoma (PH) is a major complication after endovascular treatment (EVT) for ischemic stroke. The hypoperfusion intensity ratio (HIR) represents a perfusion parameter reflecting arterial collateralization and cerebral microperfusion in ischemic brain tissue. We hypothesized that HIR correlates with the risk of PH after EVT. Methods: Retrospective multicenter cohort study of patients with large vessel occlusion who underwent EVT between 2013 and 2021 at one of the 2 comprehensive stroke centers (University Medical Center Hamburg-Eppendorf, Germany and Stanford University School of Medicine, CA). HIR was automatically calculated on computed tomography perfusion studies as the ratio of brain volume with time-to-max (Tmax) delay 〉 10 s over volume with Tmax 〉 6 s. Reperfusion hemorrhages were assessed according to the Heidelberg Bleeding Classification. Primary outcome was PH occurrence (PH+) or absence (PH−) on follow-up imaging. Secondary outcome was good clinical outcome defined as a 90-day modified Rankin Scale score of 0 to 2. Results: A total of 624 patients met the inclusion criteria. We observed PH in 91 (14.6%) patients after EVT. PH+ patients had higher HIR on admission compared with PH− patients (median, 0.6 versus 0.4; P 〈 0.001). In multivariable regression, higher admission blood glucose (adjusted odds ratio [aOR], 1.08 [95% CI, 1.04–1.13] ; P 〈 0.001), extensive baseline infarct defined as Alberta Stroke Program Early CT Score ≤5 (aOR, 2.48 [1.37–4.42]; P =0.002), and higher HIR (aOR, 1.22 [1.09–1.38]; P 〈 0.001) were independent determinants of PH after EVT. Both higher HIR (aOR, 0.83 [0.75–0.92]; P 〈 0.001) and PH on follow-up imaging (aOR, 0.39 [0.18–0.80]; P =0.013) were independently associated with lower odds of achieving good clinical outcome. Conclusions: Poorer (higher) HIR on admission perfusion imaging was strongly associated with PH occurrence after EVT. HIR as a surrogate for cerebral microperfusion might reflect tissue vulnerability for reperfusion hemorrhages. This automated and quickly available perfusion parameter might help to assess the need for intensive medical care after EVT.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.122.040540
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2023
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Favorable Venous Outflow Profiles Correlate With Favorable Tissue-Level Collaterals and Clinical Outcome
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. 5 ( 2021-05), p. 1761-1767
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 5 ( 2021-05), p. 1761-1767
    Kurzfassung: Patients with acute ischemic stroke due to large vessel occlusion and favorable tissue-level collaterals (TLCs) likely have robust cortical venous outflow (VO). We hypothesized that favorable VO predicts robust TLC and good clinical outcomes. Methods: Multicenter retrospective cohort study of consecutive acute ischemic stroke due to large vessel occlusion patients who underwent thrombectomy triage. Included patients had interpretable prethrombectomy computed tomography, computed tomography angiography, and cerebral perfusion imaging. TLCs were measured on cerebral perfusion studies using the hypoperfusion intensity ratio (volume ratio of brain tissue with [Tmax 〉 10 s/Tmax 〉 6 s]). VO was determined by opacification of the vein of Labbé, sphenoparietal sinus, and superficial middle cerebral vein on computed tomography angiography as 0, not visible; 1, moderate opacification; and 2, full. Clinical and demographic data were determined from the electronic medical record. Using multivariable regression analyses, we determined the association between VO and (1) favorable TLC status (defined as hypoperfusion intensity ratio ≤0.4) and (2) good functional outcome (modified Rankin Scale score, 0–2). Results: Six hundred forty-nine patients met inclusion criteria. Patients with favorable VO were younger (median age, 72 [interquartile range (IQR), 62–80] versus 77 [IQR, 66–84] years), had a lower baseline National Institutes of Health Stroke Scale (median, 12 [IQR, 7–17] versus 19 [IQR, 13–20] ), and had a higher Alberta Stroke Program Early Computed Tomography Score (median, 9 [IQR, 7–10] versus 7 [IQR, 6–9] ). Favorable VO strongly predicted favorable TLC (odds ratio, 4.5 [95% CI, 3.1–6.5]; P 〈 0.001) in an adjusted regression analysis. Favorable VO also predicted good clinical outcome (odds ratio, 10 [95% CI, 6.2–16.0]; P 〈 0.001), while controlling for favorable TLC, age, glucose, baseline National Institutes of Health Stroke Scale, and good vessel reperfusion status. Conclusions: In this selective retrospective cohort study of acute ischemic stroke due to large vessel occlusion patients undergoing thrombectomy triage, favorable VO profiles correlated with favorable TLC and were associated with good functional outcomes after treatment. Future prospective studies should independently validate our findings.
    Materialart: Online-Ressource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.120.032242
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2021
    ZDB Id: 1467823-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Imaging Factors Associated With Poor Outcome in Patients With Basilar Artery Occlusion Treated With Endovascular Thrombectomy
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke: Vascular and Interventional Neurology Vol. 3, No. 3 ( 2023-05)
    Details
    In: Stroke: Vascular and Interventional Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 3, No. 3 ( 2023-05)
    Kurzfassung: Acute ischemic stroke attributed to basilar artery occlusion (BAO) results in high rates of death and significant morbidity. Endovascular thrombectomy an effective treatment for BAO, but imaging parameters that predict a favorable response to thrombectomy are not well defined. We determined which imaging parameters were associated with poor outcome in patients with BAO treated by thrombectomy. Methods We performed a retrospective cohort study of patients with BAO who underwent thrombectomy at multiple international stroke centers. All patients underwent computed tomography or magnetic resonance perfusion imaging before treatment. Clinical and imaging variables were measured and correlated to poor functional outcomes (modified Rankin scale score ≥4) after thrombectomy. Imaging variables included the following: Critical Area Perfusion Score, Posterior Circulation Alberta Stroke Program Early Computed Tomography Score, ischemic core volume (30% cerebral blood flow on computed tomography perfusion or diffusion‐weighted imaging), and volume of time to maximum 〉 10 seconds. Clinical and imaging variables associated with poor functional outcome were assessed by a multivariable binary logistic regression analysis. Results A total of 102 patients were included in the study. Median patient age was 66.5 years (interquartile range [IQR], 55–78), median presentation National Institutes of Health Stroke Scale score was 14 (IQR, 7–23), and the median time from last seen normal was 4 hours (IQR, 1:52–9:20). Patient age (odds ratio [OR] , 1.37 per 5‐year increment [95% CI, 1.08–1.72]; P=0.008), presentation National Institutes of Health Stroke Scale score (OR, 1.11 [95% CI, 1.04–1.18] ; P=0.001), successful reperfusion after thrombectomy (OR, 0.03 [95% CI, 0.003–0.25]; P=0.002), Posterior Circulation Alberta Stroke Program Early Computed Tomography Score ≤6 (OR, 11.40 [95% CI, 1.73–75] ; P=0.011), and Critical Area Perfusion Score 〉 3 (OR, 26.22 [95% CI, 1.07–642]; P =0.045) independently predicted poor outcome after BAO thrombectomy. Ischemic core volume (30% cerebral blood flow) and volume of time to maximum 〉 10 seconds did not predict poor outcome. Conclusion Age, National Institutes of Health Stroke Scale presentation, unsuccessful reperfusion, Critical Area Perfusion Score 〉 3, and Posterior Circulation Alberta Stroke Program Early Computed Tomography Score ≤6 are independently associated with poor outcome after BAO thrombectomy.
    Materialart: Online-Ressource
    ISSN: 2694-5746
    URL: Article
    DOI: 10.1161/SVIN.122.000767
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2023
    ZDB Id: 3144224-9
    Standort Signatur Einschränkungen Verfügbarkeit
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