Futile recanalization is associated with increased risk of post-stroke epilepsy.
J Neurol Sci
; 462: 123067, 2024 Jul 15.
Article
in En
| MEDLINE
| ID: mdl-38823064
ABSTRACT
BACKGROUND:
Endovascular treatment (EVT) is the standard of care of ischaemic stroke due to occlusion of large vessels. Although EVT can significantly improve short- and long-term outcomes, functional dependence can persist despite the achievement of a successful recanalization. The evidence about the predictors of post-stroke epilepsy (PSE) in patients with stroke treated by EVT is limited. We aimed to evaluate the relationship between futile recanalization and the risk of PSE.METHODS:
We retrospectively identified consecutive adults with first-ever ischaemic stroke of anterior circulation who were treated with EVT. Futile recanalization was defined as poor 3-month functional status (modified Rankin scale score ≥ 3) despite complete or near-complete recanalization. Study outcome was the occurrence of PSE during the follow-up.RESULTS:
The study included 327 patients with anterior circulation ischaemic stroke treated with EVT. Futile recanalization occurred in 116 (35.5%) patients and 26 (8.0%) developed PSE during a median follow-up of 35 [interquartile range, 22.7-55.2] months. Futile recanalization was more common among patients who developed PSE compared to those who did not (76.9% versus 31.9%; p < 0.001). Futile recanalization [hazard ratio (HR) = 5.63, 95% confidence interval (CI) 1.88-16.84; p = 0.002], large artery atherosclerosis (HR = 3.48, 95% CI 1.44-8.40; p = 0.006), cortical involvement (HR = 15.51, 95% CI 2.06-116.98; p = 0.008), and acute symptomatic status epilepticus (HR = 14.40, 95% CI 2.80-73.98; p = 0.001) increased the risk of PSE.CONCLUSIONS:
Futile recanalization after EVT is associated with increased risk of PSE in patients with ischaemic stroke due to occlusion of large vessel of the anterior circulation.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Epilepsy
/
Endovascular Procedures
/
Ischemic Stroke
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Neurol Sci
Year:
2024
Document type:
Article
Country of publication:
Países Bajos