title: Outcomes of a contemporary cohort of 536 consecutive patients with acute ischemic stroke treated with endovascular therapy.
abstract: OBJECTIVE
  We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome.
  
  
  METHODS
  We used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusion therapies for consecutive patients with acute ischemic stroke since 2011. We described outcomes overall and by subgroups (age ≤ or >80 years; onset-to-groin puncture ≤ or >6 hours; anterior or posterior strokes; previous IV recombinant tissue-type plasminogen activator or isolated endovascular treatment/therapy; revascularization or no revascularization), and determined independent predictors of good outcome (modified Rankin Scale score ≤2) and mortality at 3 months by multivariate modeling.
  
  
  RESULTS
  We analyzed 536 patients, of whom 285 received previous IV recombinant tissue-type plasminogen activator. Overall, revascularization (modified Thrombolysis In Cerebral Infarction scores, 2b and 3) occurred in 73.9%, 5.6% developed symptomatic intracerebral hemorrhages, 43.3% achieved good functional outcome, and 22.2% were dead at 90 days. Adjusted comparisons by subgroups systematically favored revascularization (lower proportion of symptomatic intracerebral hemorrhages and death rates and higher proportion of good outcome). Multivariate analyses confirmed the independent protective effect of revascularization. Additionally, age >80 years, stroke severity, hypertension (deleterious), atrial fibrillation, and onset-to-groin puncture ≤6 hours (protective) also predicted good outcome, whereas lack of previous disability and anterior circulation strokes (protective) as well as and hypertension (deleterious) independently predicted mortality.
  
  
  CONCLUSIONS
  This study reinforces the role of revascularization and time to treatment to achieve enhanced functional outcomes and identifies other clinical features that independently predict good/fatal outcome after endovascular treatment/therapy.
authors.affiliation: From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Spain (S.A., A.R., M.G.); Hospital de Bellvitge, L'Hospitalet de Llobregat, Spain (P.C., F.R., M.A.d.M.); Hospital Vall d'Hebron, Barcelona, Spain (M.R., J.A.-S., A.T.); Hospital Germans Trias i Pujol, Badalona, Spain (M.M., A.D., C.C.); Hospital Clínic i Provincial, Barcelona, Spain (V.O., A.C., J.M.M.); Hospital del Mar, Barcelona, Spain (J.R.); Hospital de Sabadell, Sabadell, Spain (D.C.); and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (J.M.-F.).
authors.forename: Sònia
authors.initials: S
authors.lastname: Abilleira
authors.forename: Pere
authors.initials: P
authors.lastname: Cardona
authors.forename: Marc
authors.initials: M
authors.lastname: Ribó
authors.forename: Mònica
authors.initials: M
authors.lastname: Millán
authors.forename: Víctor
authors.initials: V
authors.lastname: Obach
authors.forename: Jaume
authors.initials: J
authors.lastname: Roquer
authors.forename: David
authors.initials: D
authors.lastname: Cánovas
authors.forename: Joan
authors.initials: J
authors.lastname: Martí-Fàbregas
authors.forename: Francisco
authors.initials: F
authors.lastname: Rubio
authors.forename: José
authors.initials: J
authors.lastname: Alvarez-Sabín
authors.forename: Antoni
authors.initials: A
authors.lastname: Dávalos
authors.forename: Angel
authors.initials: A
authors.lastname: Chamorro
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: de Miquel
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tomasello
authors.forename: Carlos
authors.initials: C
authors.lastname: Castaño
authors.forename: Juan M
authors.initials: JM
authors.lastname: Macho
authors.forename: Aida
authors.initials: A
authors.lastname: Ribera
authors.forename: Miquel
authors.initials: M
authors.lastname: Gallofré
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality; D002548:Cerebral Revascularization; D057510:Endovascular Procedures; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012042:Registries / Q000706:statistics & numerical data; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: brain ischemia; cerebral revascularization; endovascular procedures; stroke; thrombectomy