Reperfusion Without Functional Independence in Late Presentation of Stroke With Large Vessel Occlusion-Reference-Cited by-同舟云学术

Reperfusion Without Functional Independence in Late Presentation of Stroke With Large Vessel Occlusion

Published:2022-12 Issue:12 Volume:53 Page:3594-3604
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Seker Fatih¹^ORCID,Qureshi Muhammad M.²³^ORCID,Möhlenbruch Markus A.¹^ORCID,Nogueira Raul G.⁴^ORCID,Abdalkader Mohamad²^ORCID,Ribo Marc⁵^ORCID,Caparros Francois⁶^ORCID,Haussen Diogo C.⁷^ORCID,Mohammaden Mahmoud H.⁷^ORCID,Sheth Sunil A.⁸^ORCID,Ortega-Gutierrez Santiago⁹^ORCID,Siegler James E.¹⁰^ORCID,Zaidi Syed F.¹¹,Olive-Gadea Marta⁵^ORCID,Henon Hilde⁶^ORCID,Castonguay Alicia C.¹¹^ORCID,Nannoni Stefania¹²^ORCID,Kaesmacher Johannes¹³¹⁴^ORCID,Puri Ajit S.¹⁵,Farooqui Mudassir⁹^ORCID,Salazar-Marioni Sergio⁸^ORCID,Kuhn Anna L.¹⁵^ORCID,Kiley Nicole L.²^ORCID,Farzin Behzad¹⁶^ORCID,Boisseau William¹⁶^ORCID,Masoud Hesham E.¹⁷^ORCID,Lopez Carlos Ynigo¹⁷^ORCID,Rana Ameena¹⁰,Abdul Kareem Samer¹⁸^ORCID,Sathya Anvitha²^ORCID,Klein Piers²^ORCID,Kassem Mohammad W.¹⁸^ORCID,Cordonnier Charlotte⁶^ORCID,Gralla Jan¹³^ORCID,Fischer Urs¹⁹²⁰^ORCID,Michel Patrik¹²^ORCID,Strambo Davide¹²^ORCID,Jovin Tudor G.¹⁰^ORCID,Raymond Jean¹⁶^ORCID,Zaidat Osama O.¹⁸^ORCID,Ringleb Peter A.²¹^ORCID,Nguyen Thanh N.²²²^ORCID,Nagel Simon²¹²³^ORCID

Affiliation:

1. Neuroradiology (F.S., M.A.M., ), Heidelberg University Hospital, Germany.

2. Radiology (M.M.Q., M.A., N.L.K., A.S., P.K., T.N.N.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA.

3. Radiation Oncology (M.M.Q.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA.

4. Neurology, University of Pittsburgh Medical Center, PA (R.G.N.).

5. Neurology, Vall d’Hebron Research Institute, Vall D’Hebron University Hospital, Hospital Vall d’Hebron, Barcelona, Spain (M.R., M.O.-G.).

6. University Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000 Lille, France (F.C., H.H., C.C.).

7. Neurology, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA (D.C.H., M.H.M.).

8. Neurology, UTHealth McGovern Medical School, Houston, TX (S.A.S., S.S.-M.).

9. Neurology, University of Iowa, Iowa City (S.O.-G., M.F.).

10. Cooper Neurological Institute, Cherry Hill, NJ (J.E.S., A.R., T.G.J.).

11. Neurology, University of Toledo, OH (S.F.Z.‚ A.C.C.).

12. Stroke Center, Department of Clinical Neurosciences, Department of Clinical Neurosciences‚ and Neurology Service‚ Lausanne University Hospital, University of Lausanne, Switzerland (S.N., P.M., D.S.).

13. Diagnostic and Interventional Neuroradiology (J.K., J.G.), University Hospital Bern, Switzerland.

14. Interventional and Pediatric Radiology (J.K.), University Hospital Bern, Switzerland.

15. Neurointerventional Radiology, University of Massachusetts, Worcester (A.S.P., A.L.K.).

16. Interventional Neuroradiology, Centre Hospitalier de l’Université de Montréal, Canada (B.F., W.B., J.R.).

17. Neurology, State University of New York, Upstate Medical University Hospital, Syracuse (H.E.M., C.Y.L.).

18. Neuroscience, Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH (S.A.K., M.W.K., O.O.Z.).

19. Neurology, University Hospital Bern, University of Bern, Switzerland (U.F.).

20. Neurology, University Hospital Basel, University of Basel, Switzerland (U.F.).

21. Neurology (P.A.R., S.N.), Heidelberg University Hospital, Germany.

22. Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA.

23. Neurology‚ Klinikum Ludwigshafen‚ Ludwigshafen A.R.‚ Germany (S.N.).

Abstract

Background: Reperfusion without functional independence (RFI) is an undesired outcome following thrombectomy in acute ischemic stroke. The primary objective was to evaluate, in patients presenting with proximal anterior circulation occlusion stroke in the extended time window, whether selection with computed tomography (CT) perfusion or magnetic resonance imaging is associated with RFI, mortality, or symptomatic intracranial hemorrhage (sICH) compared with noncontrast CT selected patients. Methods: The CLEAR study (CT for Late Endovascular Reperfusion) was a multicenter, retrospective cohort study of stroke patients undergoing thrombectomy in the extended time window. Inclusion criteria for this analysis were baseline National Institutes of Health Stroke Scale score ≥6, internal carotid artery, M1 or M2 segment occlusion, prestroke modified Rankin Scale score of 0 to 2, time-last-seen-well to treatment 6 to 24 hours, and successful reperfusion (modified Thrombolysis in Cerebral Infarction 2c–3). Results: Of 2304 patients in the CLEAR study, 715 patients met inclusion criteria. Of these, 364 patients (50.9%) showed RFI (ie, mRS score of 3–6 at 90 days despite successful reperfusion), 37 patients (5.2%) suffered sICH, and 127 patients (17.8%) died within 90 days. Neither imaging selection modality for thrombectomy candidacy (noncontrast CT versus CT perfusion versus magnetic resonance imaging) was associated with RFI, sICH, or mortality. Older age, higher baseline National Institutes of Health Stroke Scale, higher prestroke disability, transfer to a comprehensive stroke center, and a longer interval to puncture were associated with RFI. The presence of M2 occlusion and higher baseline Alberta Stroke Program Early CT Score were inversely associated with RFI. Hypertension was associated with sICH. Conclusions: RFI is a frequent phenomenon in the extended time window. Neither magnetic resonance imaging nor CT perfusion selection for mechanical thrombectomy was associated with RFI, sICH, and mortality compared to noncontrast CT selection alone. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04096248.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference35 articles.

1. Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct

2. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging

3. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

4. European Stroke Organisation (ESO) – European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischaemic StrokeEndorsed by Stroke Alliance for Europe (SAFE)

5. Assessment of Optimal Patient Selection for Endovascular Thrombectomy Beyond 6 Hours After Symptom Onset

Cited by 38 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Unsuccessful Recanalization versus Medical Management of Patients with Large Ischemic Core;Clinical Neuroradiology;2024-02-06

2. MARVEL: A Randomized Double‐Blind, Placebo‐Controlled Trial in Patients Undergoing Endovascular Therapy: Study Rationale and Design;Stroke: Vascular and Interventional Neurology;2024-01-27

3. Neuroprotection during Thrombectomy for Acute Ischemic Stroke: A Review of Future Therapies;International Journal of Molecular Sciences;2024-01-10

4. Baseline neurologic deficit and efficacy of remote ischemic conditioning after acute ischemic stroke: A post hoc analysis of RICAMIS;Neurotherapeutics;2024-01

5. A Cortically-Weighted Versus Total Alberta Stroke Program Early Computed Tomography Score in Thrombectomy Outcome Models;Journal of Stroke and Cerebrovascular Diseases;2024-01