Analysis of prognostic factors of endovascular therapy in 59 patients with acute anterior circulation stroke: a retrospective cohort study – observational.
BACKGROUND
Endovascular therapy (ET) is increasingly used for stroke patients out of the time window, based on the multimodal treatment (MMT) it can be used alone or in combination. The purpose of this study was to assess the outcome of intra-arterial thrombolysis (IAT) and MMT for acute anterior circulation ischemic stroke (ACIS), and reveal prognostic factors of ET in the authors' stroke center.


METHODS
A retrospective analysis of the data of 59 patients with ACIS who received ET from 2010 to 2014 in the stroke center was performed. A univariate analysis was conducted to reveal the differences between IAT and MMT, and the distinctions between favorable and unfavorable outcomes, logistic regression analysis was performed to determine the predictors of outcomes.


RESULTS
Thirty-four patients who accepted MMT had a higher baseline National Institutes of Health Stroke Scale score on admission (18.3 ± 4.2) compared with 25 patients who were treated with IAT (12.6 ± 4.3). The MMT group had a higher patent flow (23/34) (thrombolysis in myocardial infarction grade 2-3) compared with the IAT group (10/25). Moreover, the MMT group had a longer time for emergency department (ED) (5.8 ± 1.4) than the IAT group (5.2 ± 0.8). In multivariate analysis, age, time to ED, and NIHSS score at discharge are predictors for poor outcome, whereas perfect recanalization was associated with favorable outcome.


CONCLUSIONS
MMT might be suitable for patients with a severe admission NIHSS and a higher patency rate than IAT. Vessel recanalization was the only predictor for favorable outcome.
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China.
Yang
Y
Yang
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China. Electronic address: chunyangliang@126.com.
Chunyang
C
Liang
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China.
Qiang
Q
Zhang
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China.
Chunsen
C
Shen
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China.
Shang
S
Ma
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China.
Jinlong
J
Mao
Department of Neurosurgery, Affiliated Bayi Brain Hospital, General Hospital of Beijing Military Region, Beijing, China.
Ruxiang
R
Xu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014481:United States
Anterior circulation occlusion; Endovascular therapy; Intra arterial thrombolysis; Multimode therapy; Stroke