Role of early decompressive craniectomy in traumatic brain injury: Our clinical experience.

BACKGROUND: Traumatic brain injury (TBI) is an important cause of death, especially in underdeveloped and developing countries. Diffuse edema in the damaged cerebral tissue as a result of trauma and the subsequent increase in intracranial pressure cause signifi-cant neurological deterioration. Consequently, decompressive craniectomy (DC) is performed as the surgical treatment of TBI. The aim of this study is to evaluate the post-operative mortality and morbidity rates of patients who underwent DC for TBI in our clinic. METHODS: The data of 57 cases of TBI were retrospectively analyzed. Clinical, radiological and surgical features of these cases were reviewed. The rates of mortality and morbidity, as well as main indicators of mortality were investigated. RESULTS: Twenty-five (43.8%) patients were female and 32 (56.1%) were male. The mean age was 54.5 years. Fourteen (24.5%) patients were presented with subdural hematoma, 5 (8.7%) with epidural hematoma, 18 (31.5%) with intracerebral hematoma, 13 (22.8%) with subarachnoid hemorrhage, and 7 (12.2%) with other radiological findings. DC was performed in all cases as soon as pos-sible after admission. Twelve (21.1%) patients died in the first 3 days postoperatively and 7 (12.2%) patients in the postoperative 3-15 days due to progressive cerebral damage and secondary infections. Six (10.5%) patients recovered completely and were discharged. Thirty-two (56.1%) patients were transferred to palliative care clinics and physical therapy clinics after the surgical treatment. CONCLUSION: DC, which is performed in the early period of treatment in TBI, is as important as the degree of intracerebral damage at the time of admission and the high Glasgow coma scale score. Post-operative results are more satisfactory in patients who underwent DC at an earlier stage of treatment.

Predictors of Symptomatic Hemorrhage After Endovascular Treatment for Anterior Circulation Occlusions: Turkish Endovascular Stroke Registry.

We evaluated the predictive factors of symptomatic intracranial hemorrhage (SICH) in endovascular treatment of stroke. We included 975 ischemic stroke patients with anterior circulation occlusion. Patients that had hemorrhage and an increase of ≥4 points in their National Institutes of Health Stroke Scale (NIHSS) after the treatment were considered as SICH. The mean age of patients was 65.2±13.1 years and 469 (48.1%) were women. The median NIHSS was 16 (13-18) and Alberta Stroke Program Early CT 9 (8-10). In 420 patients (43.1%), modified Rankin Scale was favorable (0-2) and mortality was observed in 234 (24%) patients at the end of the third month. Patients with high diastolic blood pressure (P<.05) had significantly higher SICH. SICH was significantly higher in those with high NIHSS scores (P<.001), high blood glucose (P<.001), and leukocyte count at admission (P<.05). Diabetes mellitus (DM) (OR 1.90; P<.001), NIHSS (OR 1.07; P<.05), adjuvant intra-arterial thrombolytic therapy (IA-rtPA) (OR, 1.60; P<.05), and puncture-recanalization time (OR 1.01; P<.05) were independent factors of SICH. Higher baseline NIHSS score, longer procedure time, multiple thrombectomy maneuvers, administration of IA-rtPA, and the history of DM are independent predictors of SICH in anterior circulation occlusion.

How does the use of antiplatelet and anticoagulants affect the success of mechanical thrombectomy in acute ischemic stroke cases?

Background and purpose: In this study, we wanted to investigate the effect of antiplatelet and anticoagulant use on the success of mechanical thrombectomy in acute ischemic stroke cases. Methods: 174 patients who were brought to the Stroke Center of Gaziantep University Sahinbey Research and Practice Hospital between January 2018 and February 2019 due to acute ischemic stroke and who underwent mechanical thrombectomy were retrospectively analyzed. The demographic characteristics, antiplatelet/anticoagulant use before the stroke and mTICI (modified-Throm-bolysis-In-Cerebral-Infarction) scores used for reperfusion in mechanical thrombectomy were evaluated. The findings were analyzed statistically (p<0.05). Results: The mean age was 63.3 ± 13.5 in 174 patients who underwent mechanical thrombectomy. 23/174 (13.2%) patients were using anticoagulant therapy (warfarin-OAC or new generation oral anticoagulant-NOAC) and 28/174 (16.1%) were using antiplatelet therapy. A history of atrial fibrillation (AF) was significantly higher in patients receiving anticoagulant therapy before acute ischemic stroke (p=0.001). Patients with a history of hyper tension (HT), diabetes mellitus (DM) and coronary artery disease (CAD) before acute ischemic stroke were receiving antiplatelet therapy in higher rates (respectively; p=0.003, p=0.037, p=0.005). Successful recanalization (mTICI ≥ 2b) was higher in patients with a history of anticoagulant use and who underwent mechanical thrombectomy (p=0.025). Conclusion: Our study showed that the use of anti-platelet or anticoagulants before mechanical thrombec-tomy may have an indirect positive effect on the success of the procedure.

COVID-19 pneumonia following double-sleeve lobectomy for lung cancer.

Here, we report a 54-year-old man who underwent double-sleeve left upper lobectomy for lung cancer and his postoperative course was complicated with COVID-19 pneumonia. Five days after his discharge from hospital, he was re-admitted with mild fever and bilateral multiple ground glass opacities on his chest CT. PCR testing confirmed COVID-19 infection and he was treated according to policies established by our nation's health authority. He is still receiving adjuvant chemotherapy and remains well at 3 months after the operation.

Favorable first-pass recanalization rates with NeVa™ thrombectomy device in acute stroke patients: Initial clinical experience.

BACKGROUND: The NeVa™ thrombectomy device (Vesalio LLC, Nashville, USA) has been reported to succeed in large vessel occlusion thrombectomy in animal, in-vitro, and clinical studies. Designed with Drop Zone technology, a closed distal tip, and strong expansive radial force, the device demonstrated particular efficiency in resistant "white" thrombi in preclinical research. Our goal is to determine the safety and performance of this novel stent retriever on first-pass rates and overall recanalization. METHODS: The Interventional Neurology Database is a prospectively maintained database of anterior and posterior circulation stroke thrombectomy cases. We retrospectively analyzed cases where the NeVa™ thrombectomy device was used as the first-line treatment strategy. Data collection occurred between January 2019 and January 2020. First-pass recanalization, final recanalization, 90-day functional outcome, complication, and bleeding rates are reported. RESULTS: One hundred eighteen patients were treated with the NeVa™ thrombectomy device. The mean patient age was 69 ± 14 years, the median baseline National Institutes of Health Stroke Scale was 14, and the median initial Alberta Stroke Program Early Computed Tomography score was 8. The median time from groin puncture to successful recanalization was 29 min (interquartile range (IQR): 20-40). First-pass recanalization rates were 56.8% (modified treatment in cerebral infarction (mTICI) 2b/3) and 44.9% (mTICI 2c/3). Final successful recanalization rate was 95.8% (thrombolysis in cerebral infarction 2b/3). Favorable functional outcome (modified Rankin Scale 0-2) was 53% in the "first-pass" subgroup and 42.4% in the total patient population. The median number of passes to achieve the final recanalization score was 1 (IQR 1-2). The rate of embolization into new territory was 1.7%. Four patients (3.3%) had symptomatic hemorrhage. CONCLUSIONS: In our experience, the NeVa™ device demonstrated high first-pass and overall recanalization rates along with a good safety profile.

Carotid Near-Occlusion Stent Experiences.

INTRODUCTION: Treatment strategy for near-occlusions (NO) of the internal carotid artery (ICA) is still controversial. In this study, we aimed to present the clinical results of stent placement in 50 patients with carotid artery (NO) stenosis that presented to our center, and upon which revascularization will be performed. METHODS: Between 2014 and 2017, 50 patients with (NO) from 180 patients who had stents in the Interventional Vascular Neurology clinic were retrospectively studied. All the patients whether using or not using the proximal and distal protection device during the procedure were included. Patients had clinical neurologic evaluation, and underwent carotid artery radiologic imaging before the carotid artery stent (CAS) procedure. Balloon dilatation was applied before the stent procedure for patients that had advanced stenosis. Post-dilatation was applied with a balloon of appropriate size in case of residual narrowing. Findings such as bradycardia, hypotension, reperfusion hemorrhage during and after the stent placement procedure, as well as patients that developed restenosis within 12 months were recorded. RESULTS: This study includes 50 (30 males, 20 females) patients that underwent carotid stent placement. The mean age of patients was 65 (28-81). Reperfusion hemorrhage was seen in 1 (2%) patient and the patient died in week 3. Ten (20%) patients complained of chills and tremor lasting less than 3 hours after the procedure. One (2%) patient had encephalopathy and agitation for less than 24 hours. Two (4%) patients had hypotension, and 15 (30%) patients had a headache for less than 24 hours. Three patients developed local hematoma at the site of the sheath, and were treated by applying compression. Restenosis signs in the stent site was observed in 6 patients (12%) in color Doppler ultrasonography of the carotid performed in the 6th and 12th months. CONCLUSION: Although the innate process of ICA NO is not well known, it might be more frequent than currently considered. Especially after the diagnosis of ICA stenosis, it is important to make the right diagnosis in patients that have new ipsilateral symptoms. After the diagnosis is made, CAS, when performed by an experienced neuro-interventional team, seems beneficial with low complication rates.

Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke.

PURPOSE: In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy. MATERIALS AND METHODS: This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement. RESULTS: Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0-2) was 38% (8/21). CONCLUSION: DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.

The effects of neutrophil to lymphocyte and platelet to lymphocyte ratios on prognosis in patients undergoing mechanical thrombectomy for acute ischemic stroke.

INTRODUCTION: The aim of the study was to investigate the effect of neutrophil lymphocyte (NLR) and platelet lymphocyte ratio (PLR) on prognosis in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy. MATERIAL-METHOD: A retrospective study was made of the data of 56 patients aged 20-80 years who were diagnosed with AIS and underwent mechanical thrombectomy. Thrombolysis in Brain Ischemia (TIBI) status was evaluated with transcranial Doppler after treatment. The National Institutes of Health Stroke Scale (NIHHS) and modified Rankin scale (mRS) were used to indicate neurological and functional deficits. RESULTS: No difference was determined in the NLR and PLR between patients with or without middle cerebral artery (MCA) occlusion, T and basilar occlusion. These ratios were also no different between the groups with different degrees of recanalization. Platelet lymphocyte ratio was lower in patients with a dramatic improvement at the 24th hour (p=0.046). Neutrophil lymphocyte ratio was higher in patients with symptomatic hemorrhage (p=0.046). CONCLUSION: Although no relationship with outcome has yet been shown, the association with hemorrhagic change and the recovery parameters at the 24th hour may enable NLR and PLR to be used as significant prognostic factors in patients with acute ischemic stroke undergoing mechanical thrombectomy. Further studies are needed. KEY WORDS: Ischemia, Mechanical thrombectomy, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio, Stroke.

Evaluation of BPPV with vertebral artery values.

OBJECTIVES: The aim of this study was to investigate the association between benign paroxysmal positional vertigo (BPPV) and vertebral artery (VA) flow rates and diameters by using Doppler ultrasonography in patients with BPPV. Additionally, we aimed to investigate the abnormalities of VA values obtained by extracranial color-coded duplex sonography in BPPV, which could be accepted as a precursor lesion for posterior cerebral ischemic stroke. MATERIALS AND METHODS: Between September 2017 to February 2018, 50 patients diagnosed with BPPV were enrolled in this study. Otorhinolaryngology medical examination and medical history assessment were performed at the otorhinolaryngology clinic. Afterward, neurologic examination and ultrasonography of VAs was undertaken in the neurology clinic of University of Gaziantep Medical Faculty. RESULTS: The types of BPPV found were as follows: right posterior in 27 (54%), right lateral in 4 (8%), left posterior in 16 (32%), and left lateral in 3 (6%), respectively. The most common variables found in the BPPV were smoking (26%), hypertension (26%), and hyperlipidemia (22%). CONCLUSION: VA flow rates and diameters were found to be affected at the site of BPPV. These findings might suggest that BPPV could be related to an atherosclerotic milieu and may be a precursor clinical condition for future intracranial atherosclerotic diseases.

Sexual dysfunction and distress in premenopausal women with migraine: association with depression, anxiety and migraine-related disability.

Migraine is a chronic disorder associated with impaired quality of life as well as sexual function. However, data about the sexual distress in women with migraine were lacked.This study aimed to determine the incidence and associated risk factors of both sexual function and distress in premenopausal women with migraine. Sixty-nine women diagnosed with migraine were included. Sexual function and distress were assessed by Female sexual function index (FSFI) and Female sexual distress scale-revised (FSDS-R), respectively. Depression and anxiety were investigated by Hospital depression and anxiety scale (HADS). Migraine related disability was evaluated by Migraine disability assessment scale (MIDAS) and average severity of pain was determied by Visual analog scale (VAS). Fifty-five women reported to have sexual dysfunction. Any headache-related feature including MIDAS and VAS scores, depression or anxiety was found to be related with sexual dysfunction. Sexual distress was noted in 37 cases, and depression, VAS and MIDAS scores were significantly higher in women with sexual distress. This study showed that women with migraine should be screened both for sexual dysfunction and distress to help clinicians dealing with sexual medicine to improve the standart of patient care in their regular practice. Special attention should be given to the ones whose MIDAS and VAS scores were high and who had depression.

Mean Platelet Volume, C-Reactive Protein, and Prognosis in Patients with Acute Ischemic Stroke Following Intravenous Thrombolytic Treatment.

BACKGROUND The aim of this study was to investigate the association between mean platelet volume (MPV), C-reactive protein (CRP), and prognosis in patients with acute ischemic stroke (AIS) following intravenous (IV) thrombolytic treatment. MATERIAL AND METHODS A retrospective clinical study included 129 patients within 4.5 hours from the onset of AIS, who received IV thrombolytic treatment. Clinical data were retrieved from electronic medical records. MPV, CRP, and National Institutes of Health (NIH) Stroke Scale and the modified Rankin Scale (MRS) scores for physical disability were recorded. RESULTS Of the 129 patients, 65.9% were men, and more than half received IV thrombolytic treatment within between 3-4.5 hours. The NIH Stroke Scale scores at 24 hours and at three months after hospital admission were compared with the NIH Stroke Scale scores on hospital admission. A significant correlation was found between the MPV values at 24 hours (r=0.221; p=0.012) and at three months after hospital admission (r=196; p=0.026). There was a significant correlation between CRP values at 24 hours (r=0.224; p=0.021), the difference in NIH Stroke Scale score between 24 hours and three months (r=0.249; p=0.005), and the MPV score at three months (r=0.186; p=0.035). CONCLUSIONS MPV and CRP values were significantly associated with improvement in the NIH Stroke Scale and MRS scores in AIS when patients were treated with IV thrombolytic therapy within 4.5 hours of the onset of symptoms.

The effects of Maras powder use on patients with migraine.

BACKGROUND: It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. SUBJECTS AND METHODS: The study included a total of 600 subjects, consisting of 300 patients (aged >18 years) diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta) criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. RESULTS: In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001). The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001). The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001). When patients were evaluated according to the Migraine Disability Assessment Scale, the majority of migraine patients were seen to be at stages 1 and 2, and one in every three patients who used Maras powder cigarette and one in every two patients who smoked had headaches of a severity which affected their daily activities (p<0.001). CONCLUSION: Smoking or the use of Maras powder increases the frequency and severity of migraines in a similar way. Therefore, Maras powder must be included in the scope of the fight against tobacco and people should be warned about this issue.

The effect of demographic features on aortic arch anatomy and its role in the etiology of cerebrovascular disease.

PURPOSE: The aim of this study was to retrospectively evaluate the distribution of aortic arches, the relationship with demographic characteristics, and the results of carotid and vertebral artery stenting procedures in patients diagnosed with cerebrovascular disease through the intra-arterial digital subtraction angiography (DSA) technique. METHODS: A retrospective examination was performed on 288 patients diagnosed with cerebrovascular disease, who underwent DSA in the Department of Neurology of Gaziantep University Medical Faculty and Kahramanmaras¸ Sütçü Imam University Medical Faculty. The patients were examined in respect of demographic features and aortic arch anatomic structure characteristics. All demographic characteristics, DSA, carotid, and vertebral artery stent results were recorded. RESULTS: The patients comprised 60.1% males and 39.9% females with a mean age of 58.25 years. Type 2 aortic arch was found in 175 (60.7%) patients, Type 2 aortic arch in 99 (34.3%) patients, and Type 3 aortic arch in 14 (4.8%) patients. The right carotid artery stenosis rate was found to be higher in patients with Type 2 aortic arch (P=0.013). When the patients were evaluated according to the presence of a bovine arch, there was no significant difference in terms of age, carotid, and vertebral artery lesions (P>0.05). CONCLUSION: The aortic arch and its branching properties were not found to have a direct effect on increased risk of cerebrovascular disease or stenting rates. This study can be considered to raise awareness for new studies to demonstrate the effect of aortic arch anatomic differences on cerebrovascular diseases.

Carotid artery stenting without using any embolic protective device A single Centre experience.

INTRODUCTION: Despite the use of embolic protective devices in the majority of cases applied with carotid stenting to prevent embolic neurological complications related to the carotid stenting procedure, this procedure is applied to some cases without protection. The aim of this study was to present the clinical outcomes of carotid artery stent application without a cerebral embolism protective device. MATERIAL AND METHOD: A retrospective examination was made of a total of 171 patients applied with a stent between 2014 and 2017. The patients included in the study were applied with a stent because they were symptomatic and determined with >50% narrowing in the carotid artery on angiography or asymptomatic with >60% narrowing. The degree of carotid artery narrowing was determined with Doppler ultrasonography before angiographic examination and with the North American symptomatic carotid endarterectomy trial measurement criteria during angiography. After stenting the carotid artery, patients were observed at the hospital for 24 hours RESULTS: In 10 (5.8%) patients, there was a mid cerebral artery branch infarct ipsilateral to the stent. No reperfusion bleeding was observed in any patient. In 5 (2.9%) patients, encephalopathy and agitation not exceeding 24 hours was observed. Hypotension was determined in 8 (4.6%) patients and headache lasting <24 hours in 53 (31%) patients. 1 (0.5%) patient, rectus abdominis bleeding developed one week after the procedure and within 24 hours, the patient was exitus. CONCLUSION: Revascularisation interventions to be able to prevent the development of stroke are evaluated as important treatment options in patients with symptomatic or severe carotid stenosis. With careful patient selection in experienced centres and a multi-disciplinary approach both before and after the procedure, pleasing results can be obtained without the use of embolic protective devices. KEY WORDS: Carotid artery stenting, Embolic protective device, Stroke.

Lack of association between urotensin-II (UTS2) gene polymorphisms (Thr21Met and Ser89Asn) and migraine.

Migraine is a common neurovascular brain disorder with heterogeneous clinical presentation, including recurrent headache attacks. The pathophysiology of migraine is complex, and a number of genomic regions have been associated with the development of migraine. In this study, we analyzed the allele and genotype frequencies of the urotensin-II gene (UTS2) polymorphisms, Thr21Met and Ser89Asn, among Turkish patients with migraine. A total of 146 patients with migraine (14 with aura [MA group] and 132 without aura [MO group]) were genotyped for Thr21Met and Ser89Asn polymorphisms and compared with 154 age- and sex-matched healthy controls. The UTS2 gene polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). No significant differences were observed in allele and genotype frequencies for Thr21Met and Ser89Asn polymorphisms between the patients with migraine and control group. Similarly, we did not observe significant differences in allele and genotype frequencies between MA and MO and control group. Moreover, the haplotype analysis showed no association between UTS2 gene haplotypes (MN, MS, TN, and TS) and migraine. In summary, Thr21Met and Ser89Asn polymorphisms of the UTS2 gene are not risk factors for migraine in our sample of Turkish migraine patients.

Does stroke etiology play a role in predicting outcome of acute stroke patients who underwent endovascular treatment with stent retrievers?

AIMS: The goal of the study was to identify whether the stroke etiology play a role in the recanalization and outcome of patients who underwent mechanical thrombectomy with stent retrievers. METHODS AND RESULTS: A retrospective analysis of a prospectively collected database included consecutive patients treated with stent retrievers. We included patients with cardioembolic stroke and large vessel atherosclerotic disease and compared risk factors for stroke, baseline NIHSS and Alberta Stroke Program Early CT scores (ASPECTS), stroke outcome, recanalization rate, onset-to-recanalization, onset-to-groin puncture time and the procedural time between two groups. Male sex was statistically more common in patients with large vessel atherosclerotic disease. Mean time from symptom onset- to the achievement of recanalization in patients with LVAD was 242±72.4 compared with cardioembolic stroke patients (301±70.7; p=0.014). Time for groin puncture to recanalization was longer in patients with cardioembolic stroke compared to LVAD group (97.5±44.3 vs 58.2±21.8; p=0.002). Time for microcatheter to successful recanalization or procedural termination was longer in patients with cardioembolic stroke compared to LVAD group (63.6±30.2 vs 34.2±19.4; p<0.001) with cardioembolic stroke had significantly worse long-term outcome (mRS 3-6) compared to those with LVAD (60.6% vs 26.3%; p=0.036). CONCLUSION: Stroke etiology may play a role in the outcome of acute stroke patients who underwent endovascular stroke therapy. Cardioembolic strokes may be more resistant to endovascular acute stroke treatment.

Predictors of a Good Outcome after Endovascular Stroke Treatment with Stent Retrievers.

BACKGROUND AND PURPOSE: Successful recanalization after endovascular stroke therapy (EVT) did not translate into a good clinical outcome in randomized trials. The goal of the study was to identify the predictors of a good outcome after mechanical thrombectomy with stent retrievers. METHODS: A retrospective analysis of a prospectively collected database included consecutive patients treated with stent retrievers. We evaluated the influence of risk factors for stroke, baseline NIHSS score, Alberta Stroke Program Early CT (ASPECT) score, recanalization rate, onset-to-recanalization and onset-to-groin puncture time, and glucose levels at admission on good outcomes. The number of stent passes during procedure and symptomatic hemorrhage rate were also recorded. A modified Rankin Scale (mRS) score of 0-2 at 90 days was considered as a good outcome. RESULTS: From January 2011 to 2014, 70 consecutive patients with an acute ischemic stroke underwent EVT with stent retrievers. The absence of a medical history of diabetes was associated with good outcomes. Apart from diabetes, the baseline demographic and clinical characteristics of patients were similar between subjects with poor outcome versus those with good outcomes. Median time from onset to recanalization was significantly shorter in patients with good outcomes 245 (IQR: 216-313 min) compared with poor outcome patients (315 (IQR: 240-360 min); P = 0.023). Symptomatic intracranial hemorrhage was observed in eight (21.6%) of 37 patients with poor outcomes and no symptomatic hemorrhage was seen in patients with good outcomes (P = 0.006). In multivariate stepwise logistic regression analysis, a favorable ASPECT score (ASPECT > 7) and successful recanalization after EVT were predictors of good outcomes. Every 10-year increase was associated with a 3.60-fold decrease in the probability of a good outcome at 3 months. The probability of a good outcome decreases by 1.43-fold for each 20 mg/dL increase in the blood glucose at admission. CONCLUSION: To achieve a good outcome after EVT with stent retrievers, quick and complete recanalization and better strategies for patient selection are warranted. We need randomized trials to identify the significance of tight blood glucose control in clinical outcome during or after EVT.