title: Prognostic factors for neurologic outcome after endovascular revascularization of acute symptomatic occlusion of the internal carotid artery.
abstract: OBJECTIVE
  Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion.
  
  
  METHODS
  We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes.
  
  
  RESULTS
  Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42%) of 33 and good recovery (mRS <or=2) after 1 year in 11 (33%) of 33. Distal residual occlusion (DRO; P=.005), initial NIHSS score (P=.023), and postprocedural thrombolysis in cerebral infarction (P=.027), retrograde ICA filling (P=.036), and ophthalmic collaterals (P=.046) were significant predictors of short-term outcome. DRO (P=.018) and initial NIHSS (P=.033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term (P=.026) and long-term outcome (P=.033) on multivariable logistic regression.
  
  
  CONCLUSIONS
  Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. dcsuh@amc.seoul.kr
authors.forename: D C
authors.initials: DC
authors.lastname: Suh
authors.forename: J K
authors.initials: JK
authors.lastname: Kim
authors.forename: C G
authors.initials: CG
authors.lastname: Choi
authors.forename: S J
authors.initials: SJ
authors.lastname: Kim
authors.forename: H W
authors.initials: HW
authors.lastname: Pyun
authors.forename: C
authors.initials: C
authors.lastname: Ahn
authors.forename: D H
authors.initials: DH
authors.lastname: Yang
authors.forename: K S
authors.initials: KS
authors.lastname: Lim
authors.forename: J-G
authors.initials: JG
authors.lastname: Leem
authors.forename: K D
authors.initials: KD
authors.lastname: Hahm
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.forename: S U
authors.initials: SU
authors.lastname: Kwon
authors.forename: J S
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome