Predictors for large vessel recanalization before stroke thrombectomy: the HALT score.
J Neurointerv Surg
; 16(3): 237-242, 2024 Feb 12.
Article
em En
| MEDLINE
| ID: mdl-37100595
ABSTRACT
BACKGROUND:
Large vessel recanalization (LVR) before endovascular therapy (EVT) for acute large vessel ischemic strokes is a poorly understood phenomenon. Better understanding of predictors for LVR is important for optimizing stroke triage and patient selection for bridging thrombolysis.METHODS:
In this retrospective cohort study, consecutive patients presenting to a comprehensive stroke center for EVT treatment were identified from 2018 to 2022. Demographic information, clinical characteristics, intravenous thrombolysis (IVT) use, and LVR before EVT were recorded. Factors independently associated with different rates of LVR were identified, and a prediction model for LVR was constructed.RESULTS:
640 patients were identified. 57 (8.9%) patients had LVR before EVT. A minority (36.4%) of LVR patients had significant improvements in National Institutes of Health Stroke Scale. Independent predictors for LVR were identified and used to construct the 8-point HALT score hyperlipidemia (1 point), atrial fibrillation (1 point), location of vascular occlusion (internal carotid 0 points, M1 1 point, M2 2 points, vertebral/basilar 3 points), and thrombolysis at least 1.5 hours before angiography (3 points). The HALT score had an area under the receiver-operating curve (AUC) of 0.85 (95% CI 0.81 to 0.90, P<0.001) for predicting LVR. LVR before EVT occurred in only 1 of 302 patients (0.3%) with low (0-2) HALT scores.CONCLUSIONS:
IVT at least 1.5 hours before angiography, site of vascular occlusion, atrial fibrillation, and hyperlipidemia are independent predictors for LVR. The 8-point HALT score proposed in this study may be a valuable tool for predicting LVR before EVT.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Isquemia Encefálica
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Acidente Vascular Cerebral
/
Procedimentos Endovasculares
/
Hiperlipidemias
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Neurointerv Surg
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos