Prognostic factors for outcomes after mechanical thrombectomy with solitaire stent.
J Neuroradiol
; 40(4): 252-9, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-23684343
ABSTRACT
BACKGROUND AND PURPOSE:
Endovascular mechanical thrombectomy is emerging as a promising therapeutic approach for acute ischemic stroke. This study was aimed at identifying factors influencing outcomes after thrombectomy with a Solitaire stent device. MATERIALS ANDMETHODS:
Forty-five consecutive patients treated with thrombectomy using Solitaire FR were retrospectively included. Clinical, imaging and logistic variables were analyzed. A multivariate logistic regression analysis was used to identify variables influencing clinical outcome, based on discharge NIHSS score change and mRS at 3 months.RESULTS:
Patient mean age and initial NIHSS score was 58 years (range 24-88) and 17 (range 6-32), respectively. An MRI was performed for 80% of patients, showing severe DWI lesion for 28% of patients and associated FLAIR hyperintensity for 58% of patients. Mean time from symptom onset to recanalization was 299min for the 32 ACO and 473min for the 13 PCO. Angiographic efficacy (TICI 2b-3) was achieved for 93% of patients and good clinical outcomes at discharge and at 3 months (mRS≤2) were achieved for 49% and 58% of patients, respectively. Independent prognostic factors for predicting good clinical outcomes at discharge were a short time to recanalization and FLAIR negativity. At 3 months, they were a short time to recanalization and patient age. DWI lesion severity was an associated prognostic factor.CONCLUSION:
Two main prognostic factors for predicting a good clinical outcome after thrombectomy at 3 months were short time from symptom onset to recanalization and patient age.Palavras-chave
ACO; ASPECT; Alberta stroke program early CT; DWI; IV; NIHSS; National Institutes of Health Stroke Scale; PCO; Prognostic factors; ROC curves; Receiver Operating Characteristic curves; Stroke; TICI; Thrombectomy; anterior circulation occlusions; diffusion-weighted imaging; intravenous; mRS; modified Rankin Scale; posterior circulation occlusions; thrombolysis in cerebral infarction score
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Stents
/
Isquemia Encefálica
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Angiografia por Ressonância Magnética
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Acidente Vascular Cerebral
/
Trombólise Mecânica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Neuroradiol
Ano de publicação:
2013
Tipo de documento:
Article