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Sex Differences in Outcomes of Late-Window Endovascular Stroke Therapy.
Abdalkader, Mohamad; Ning, Shen; Qureshi, Muhammad M; Haussen, Diogo C; Strbian, Daniel; Nagel, Simon; Demeestere, Jelle; Puetz, Volker; Mohammaden, Mahmoud H; Olive Gadea, Marta; Winzer, Simon; Yamagami, Hiroshi; Tanaka, Kanta; Marto, João Pedro; Tomppo, Liisa; Henon, Hilde; Sheth, Sunil A; Ortega-Gutierrez, Santiago; Martinez-Majander, Nicolas; Caparros, Francois; Lemmens, Robin; Dusart, Anne; Bellante, Flavio; Zaidi, Syed F; Siegler, James E; Nannoni, Stefania; Kaesmacher, Johannes; Dobrocky, Tomas; Farooqui, Mudassir; Salazar-Marioni, Sergio; Virtanen, Pekka; Vandewalle, Lieselotte; Wouters, Anke; Jesser, Jessica; Ventura, Rita; Castonguay, Alicia C; Uchida, Kazutaka; Puri, Ajit S; Masoud, Hesham E; Klein, Piers; Mansoor, Zain; Bui, Jenny; Kang, Matthew; Mujanovic, Adnan; Rizzo, Federica; Kokkonen, Tatu; Ramos, João Nuno; Strambo, Davide; Michel, Patrik; Möhlenbruch, Markus A.
Afiliación
  • Abdalkader M; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
  • Ning S; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
  • Qureshi MM; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
  • Haussen DC; Radiation Oncology (M.M.Q.), Boston Medical Center.
  • Strbian D; Departments of Neurology, Grady Memorial Hospital (D.C.H., M.H.M., R.G.N.).
  • Nagel S; Departments of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, Finland.
  • Demeestere J; Department of Neurology, Klinikum Ludwigshafen, Germany (S. Nagel).
  • Puetz V; Departments of Neurology (S. Nagel, P.A.R.). Heidelberg University Hospital, Germany.
  • Mohammaden MH; Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Olive Gadea M; Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Winzer S; Department of Neurology (V.P., S.W.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
  • Yamagami H; Dresden Neurovascular Center, Germany (V.P., S.W., D.P.O.K.).
  • Tanaka K; Departments of Neurology, Grady Memorial Hospital (D.C.H., M.H.M., R.G.N.).
  • Marto JP; Department of Neurology, Hospital Vall d'Hebron, Spain (M.O.G., F.R., M.R.).
  • Tomppo L; Department of Neurology (V.P., S.W.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
  • Henon H; Dresden Neurovascular Center, Germany (V.P., S.W., D.P.O.K.).
  • Sheth SA; Department of Stroke Neurology, NHO Osaka National Hospital, Japan (H.Y.).
  • Ortega-Gutierrez S; Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (K.T.).
  • Martinez-Majander N; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
  • Caparros F; Departments of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, Finland.
  • Lemmens R; Department of Neurology, University of Lille, CHU Lille, Inserm, France (H.H., F.C., C.C.).
  • Dusart A; Department of Neurology, UTHealth McGovern Medical School, Houston (S.A.S., S.S.-M.).
  • Bellante F; Department of Neurology, University of Iowa (S.O.-G., M.F.).
  • Zaidi SF; Departments of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, Finland.
  • Siegler JE; Department of Neurology, University of Lille, CHU Lille, Inserm, France (H.H., F.C., C.C.).
  • Nannoni S; Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Kaesmacher J; Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Dobrocky T; Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium (A.D., F.B.).
  • Farooqui M; Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium (A.D., F.B.).
  • Salazar-Marioni S; Department of Neurology, University of Toledo, Toledo (S.F.Z., A.C.C.).
  • Virtanen P; Department of Neurology, University of Chicago (J.E.S.).
  • Vandewalle L; Clinical Neurosciences, University of Cambridge, United Kingdom (S. Nannoni).
  • Wouters A; Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Switzerland (J.K., T.D., A.M.).
  • Jesser J; Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Switzerland (J.K., T.D., A.M.).
  • Ventura R; Department of Neurology, University of Iowa (S.O.-G., M.F.).
  • Castonguay AC; Department of Neurology, UTHealth McGovern Medical School, Houston (S.A.S., S.S.-M.).
  • Uchida K; Radiology (P.V., T.K.), Helsinki University Hospital, Finland.
  • Puri AS; Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Masoud HE; Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Klein P; Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Mansoor Z; Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.).
  • Bui J; Radiology (J.J., M.A.M.). Heidelberg University Hospital, Germany.
  • Kang M; Departments of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Occidental, Portugal.
  • Mujanovic A; Department of Neurology, University of Toledo, Toledo (S.F.Z., A.C.C.).
  • Rizzo F; Department of Neurosurgery, Hyogo Medical University, Japan (K.U., S.Y.).
  • Kokkonen T; Interventional Neuroradiology, University of Massachusetts Memorial Medical Center (A.S.P.).
  • Ramos JN; Department of Neurology, State University of New York (H.E.M.).
  • Strambo D; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
  • Michel P; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
  • Möhlenbruch MA; Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center.
Stroke ; 55(2): 278-287, 2024 02.
Article en En | MEDLINE | ID: mdl-38252759
ABSTRACT

BACKGROUND:

The association between sex and outcome after endovascular thrombectomy of acute ischemic stroke is unclear. The aim of this study was to compare the clinical and safety outcomes between men and women treated with endovascular thrombectomy in the late 6-to-24-hour window period.

METHODS:

This multicenter, retrospective observational cohort study included consecutive patients who underwent endovascular thrombectomy of anterior circulation stroke in the late window from 66 clinical sites in 10 countries from January 2014 to May 2022. The primary outcome was the 90-day ordinal modified Rankin Scale score. Secondary outcomes included 90-day functional independence (FI), return of Rankin (RoR) to prestroke baseline, FI or RoR, symptomatic intracranial hemorrhage, and mortality. Multivariable and inverse probability of treatment weighting methods were used. We explored the interaction of sex with baseline characteristics on the outcomes ordinal modified Rankin Scale and FI or RoR.

RESULTS:

Of 1932 patients, 1055 were women and 877 were men. Women were older (77 versus 69 years), had higher rates of atrial fibrillation, hypertension, and greater prestroke disability, but there was no difference in baseline National Institutes of Health Stroke Scale score. Inverse probability of treatment weighting analysis showed no difference between women and men in ordinal modified Rankin Scale (odds ratio, 0.98 [95% CI, 0.79-1.21]), FI or RoR (odds ratio, 0.98 [95% CI, 0.78-1.22]), severe disability or mortality (odds ratio, 0.99 [95% CI, 0.80-1.23]). The multivariable analysis of the above end points was concordant. There were no interactions between baseline characteristics and sex on the outcomes of ordinal modified Rankin Scale and FI or RoR.

CONCLUSIONS:

In late presenting patients with anterior circulation stroke treated with endovascular thrombectomy in the 6 to 24-hour window, there was no difference in clinical or safety outcomes between men and women.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Fibrilación Atrial / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Stroke Año: 2024 Tipo del documento: Article
Texto completo
Imprimir
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PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Fibrilación Atrial / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Stroke Año: 2024 Tipo del documento: Article