Outcomes of late endovascular recanalization for symptomatic non-acute atherosclerotic intracranial large artery occlusion.
Clin Neurol Neurosurg
; 187: 105567, 2019 Dec.
Article
en En
| MEDLINE
| ID: mdl-31704389
ABSTRACT
OBJECTIVES:
The optimal treatment of symptomatic non-acute atherosclerotic intracranial large artery occlusion (ILAO) beyond 24â¯h from onset remains uncertain. We investigate the outcomes of late endovascular recanalization for symptomatic non-acute atherosclerotic ILAO. PATIENTS ANDMETHODS:
From September 2013 to July 2018, with safety as the first principle, late endovascular recanalization for symptomatic non-acute atherosclerotic ILAO beyond 24â¯h from onset was attempted in 32 consecutive patients. Primary safety outcome was any stroke or death within 30 days. Primary efficacy outcome were functional independence at 90 days.RESULTS:
The median time from imaging-documented occlusion to treatment was 25.5 days (interquartile range 10.5-36.5) for all patients. Technical success in recanalization was achieved in 17 patients (53.1%, 17/32). The 30-day rate of any stroke or death was 5.9% (1/17) in the recanalized group versus 6.7% (1/15) in the failure group (Pâ¯=â¯0.927). The rate of functional independence at 90 days (70.5%, 12/17) was increased significantly as compared with that before operation (23.5%, 4/17) in the recanalized group (Pâ¯=â¯0.015). The rate of functional independence at 90 days (66.7%, 10/15) was not different from that before operation (66.7%,10/15) in the failure group (Pâ¯=â¯1.00). The median score reduction in mRS from baseline at 90 days was 1.0 (interquartile range 1.0-2.0) in the recanalized group versus 0 (interquartile range 0.0-0.0) in the failure group (Pï¼0.001).CONCLUSION:
For carefully selected patients with symptomatic non-acute atherosclerotic ILAO beyond 24â¯h from onset, late endovascular recanalization is technically feasible. The periprocedural safety of late endovascular recanalization is acceptable. Successful recanalization may effectively improve the degree of disability in such patients. However, it should be emphasized that revascularization of non-acute ILAO is a high risk procedure, which should only be performed by experienced operators with safety as the first principle.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arteriopatías Oclusivas
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Arterias Cerebrales
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Arteriosclerosis Intracraneal
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Procedimientos Endovasculares
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Adult
/
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Neurol Neurosurg
Año:
2019
Tipo del documento:
Article