Delayed neurological improvement after endovascular treatment for acute large vessel occlusion: data from ANGEL-ACT registry.
J Thromb Thrombolysis
; 55(1): 1-8, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-36301460
ABSTRACT
BACKGROUND:
A subgroup of patients with acute large vessel occlusion (ALVO) may experience delayed neurological improvement (DNI) after endovascular treatment (EVT). Our study aimed to investigate the incidence and independent predictors of DNI in patients with ALVO after EVT.METHODS:
We selected subjects from ANGEL-ACT Registry. The definition of DNI is patients with ALVO who did not experience early neurological improvement (ENI) despite complete recanalization after EVT. These patients achieved a 90-day favorable outcome assessed by a modified Rankin Scale (mRS) score. We defined ENI as a ≥ 4-point decrease in the National Institutes of Health Stroke Scale (NIHSS) between baseline and 24 h or NIHSS of 0 or 1 at 24 h, with complete recanalization after EVT. We performed logistic regression analyses to determine the independent predictors of DNI.RESULTS:
Among the 1056 enrolled patients, 406 (38.4%) did not experience ENI. 106 (26.1%) patients without ENI achieved DNI. On Multivariate analysis, lower admission NIHSS score (odds ratio [OR] = 1.17,95% confidence interval [CI] 1.11-1.23, P < 0.001), underlying ICAD (OR = 2.03, 95% CI 1.07-3.85, P = 0.029) and absence of general anesthesia (OR = 2.13, 95% CI 1.24-3.64, P = 0.006) were independent predictors of DNI.CONCLUSION:
DNI occurred in 26.1% of patients with ALVO who did not experience ENI after EVT. Our study identified several independent predictors of DNI that should be highly considered in daily clinical practice to improve ALVO management.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Acidente Vascular Cerebral
/
Procedimentos Endovasculares
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
J Thromb Thrombolysis
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China