title: Neurointerventional treatment in acute stroke. Whom to treat? (Endovascular treatment for acute stroke: utility of THRIVE score and HIAT score for patient selection).
abstract: OBJECTIVE
  Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT.
  
  
  METHODS
  Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy.
  
  
  RESULTS
  Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome.
  
  
  CONCLUSIONS
  Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged ≥80 years.
authors.affiliation: Department of Radiology, Stavanger University Hospital, 4068, Stavanger, Norway, lars.fjetland@lyse.net.
authors.forename: Lars
authors.initials: L
authors.lastname: Fjetland
authors.forename: Sumit
authors.initials: S
authors.lastname: Roy
authors.forename: Kathinka D
authors.initials: KD
authors.lastname: Kurz
authors.forename: Tore
authors.initials: T
authors.lastname: Solbakken
authors.forename: Jan Petter
authors.initials: JP
authors.lastname: Larsen
authors.forename: Martin W
authors.initials: MW
authors.lastname: Kurz
mesh_terms: D000369:Aged, 80 and over; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000628:therapy*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome