title: Frequency and outcome of total anterior circulation strokes without intracranial large-vessel occlusion.
abstract: The percentage of patients with clinical total anterior circulation infarct (TACI) syndrome treated with reperfusion therapies in the absence of intracranial large-vessel occlusion (ILVO) was determined and their characteristics and outcome are described.
  
  
  
  Data from a population-based, prospective, externally audited registry of all stroke patients treated with intravenous thrombolysis (IVT) and endovascular therapies in Catalonia from January 2011 to December 2013 were used. Patients with a baseline TACI and initial stroke severity measured by the National Institute of Health Stroke Scale (NIHSS) ≥ 8, evaluated less than 4.5 h post-onset, for whom a vascular study prior to treatment was available (n = 1070) were selected. Clinical characteristics, outcome and radiological data for patients treated with IVT alone (n = 605) were compared between those with detected ILVO (n = 474) and non-ILVO patients (n = 131).
  
  
  
  A total of 1070 patients met study criteria; non-ILVO was found in 131 (12.2%). Analysing the 605 patients treated only with IVT, no significant differences were found between non-ILVO and ILVO patients in age, sex, risk factors, time-to-treatment and type of radiological studies performed. Although non-ILVO patients had lower initial stroke severity (P < 0.001) and a better prognosis (P = 0.001), 51.3% had a poor outcome and 16% were deceased at 90 days. In 66.4% of patients without ILVO, a recent anterior territorial infarct was detected.
  
  
  
  Intracranial artery patency was observed in 12.2% of TACI patients evaluated within 4.5 h. Although absence of ILVO was associated with slightly better prognosis, more than half had a poor outcome at 3 months.
authors.affiliation: Neurovascular Research Group, Neurology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Giralt-Steinhauer
authors.affiliation: Neurovascular Research Group, Neurology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ois
authors.affiliation: Stroke Programme, Catalan Agency for Health Information, Assessment and Quality (CAHIAQ), Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Abilleira
authors.affiliation: Hospital Clínic, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Urra
authors.affiliation: Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Cardona-Portela
authors.affiliation: Hospital GermansTrias i Pujol de Badalona, Badalona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gomis
authors.affiliation: Hospital Universitari JosepTrueta de Girona, Girona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Castellanos
authors.affiliation: Hospital Universitari de la Valld'Hebron, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Molina
authors.affiliation: Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Martí-Fàbregas
authors.affiliation: Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pellisé
authors.affiliation: Hospital Parc Taulí de Sabadell, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Cànovas
authors.affiliation: Hospital Moises Broggi, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gómez-Choco
authors.affiliation: Hospital Universitari Mútua Terrassa, Barcelona, Spain.|Healthcare Sciences, MMU, Manchester, UK.
authors.forename: J
authors.initials: J
authors.lastname: Kuprinski
authors.affiliation: Hospital de Granollers, Granollers, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Cocho
authors.affiliation: Neurovascular Research Group, Neurology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Roquer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
keywords: intravenous thrombolysis; ischaemic stroke; prognosis