title: Procedural predictors of outcome in patients undergoing endovascular therapy for acute ischemic stroke.
abstract: OBJECTIVE
  To identify factors impacting outcome in patients undergoing interventions for acute ischemic stroke (AIS).
  
  
  METHODS
  This was a retrospective analysis of patients undergoing endovascular therapy for AIS secondary during a 30 month period. Outcome was based on modified Rankin score at 3- to 6-month follow-up. Recanalization was defined as Thrombolysis in myocardial infarction score 2 to 3. Collaterals were graded based on pial circulation from the anterior cerebral artery either from an ipsilateral injection in cases of middle cerebral artery (MCA) occlusion or contralateral injection for internal carotid artery terminus (ICA) occlusion as follows: no collaterals (grade 0), some collaterals with retrograde opacification of the distal MCA territory (grade 1), and good collaterals with filling of the proximal MCA (M2) branches or retrograde opacification up to the occlusion site (grade 2). Occlusion site was divided into group 1 (ICA), group 2 (MCA with or without contiguous M2 involvement), and group 3 (isolated M2 or M3 branch occlusion).
  
  
  RESULTS
  A total of 89 patients were studied. Median age and National Institutes of health stroke scale (NIHSS) score was 71 and 15 years, respectively. Favorable outcome was seen in 49.4% of patients and mortality in 25.8% of patients. Younger age (P = 0.006), lower baseline NIHSS score (P = 0.001), successful recanalization (P < 0.0001), collateral support (P = 0.0008), distal occlusion (P = 0.001), and shorter procedure duration (P = 0.01) were associated with a favorable outcome. Factors affecting successful recanalization included younger age (P = 0.01), lower baseline NIHSS score (P = 0.05), collateral support (P = 0.01), and shorter procedure duration (P = 0.03). An ICA terminus occlusion (P < 0.0001), lack of collaterals (P = 0.0003), and unsuccessful recanalization (P = 0.005) were significantly associated with mortality.
  
  
  CONCLUSIONS
  Angiographic findings and preprocedure variables can help prognosticate procedure outcomes in patients undergoing endovascular therapy for AIS.
authors.affiliation: Interventional Neuroradiology, West Virginia University Health Sciences Center, Morgantown, WV 26506-9235, USA. ansaar.rai@gmail.com
authors.forename: Ansaar T
authors.initials: AT
authors.lastname: Rai
authors.forename: Yahodeep
authors.initials: Y
authors.lastname: Jhadhav
authors.forename: Jennifer
authors.initials: J
authors.lastname: Domico
authors.forename: Gerald R
authors.initials: GR
authors.lastname: Hobbs
mesh_terms: D000368:Aged; D002533:Cerebral Angiography; D002536:Cerebral Arteries; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003287:Contrast Media; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media