2019 Update of the Korean Clinical Practice Guidelines of Stroke for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke

Ko, Sang‐Bae; Park, Hong‐Kyun; Kim, Byung Moon; Heo, Ji Hoe; Rha, Joung Ho; Kwon, Sun U.; Kim, Jong Seung; Lee, Byung Chul; Suh, Sang Hyun; Jung, Cheolkyu; Jeong, Hae Woong; Kang, Dong Hun; Bae, Hee Joon; Yoon, Byung Woo; Hong, Keun Sik

doi:10.5853/jos.2019.00024

Cited by 47 publications

(33 citation statements)

References 37 publications

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“…Endovascular treatment (EVT) has become the standard therapeutic modality for patients with acute ischemic stroke (AIS). [1][2][3][4] However, the outcome of EVT may depend on the etiology of vascular occlusion. 5 Although some studies have compared the outcome of EVT in patients with occlusion associated with intracranial arterial stenosis (ICAS-O) and embolic occlusion, more studies are needed to elucidate their differences.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment in Patients with Cerebral Artery Occlusion of Three Different Etiologies

Lee

Suh

et al. 2020

J Stroke

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Background and Purpose The outcome of endovascular treatment (EVT) may differ depending on the etiology of arterial occlusion. This study aimed to assess the differences in EVT outcomes in patients with intracranial arterial steno-occlusion (ICAS-O), artery-to-artery embolism (AT-O), and cardiac embolism (CA-O).<br/>Methods We retrospectively analyzed 330 patients with ischemic stroke who underwent EVT between January 2012 and August 2017. Patients were classified according to the etiology. The clinical data, EVT-related factors, and clinical outcomes were compared. The modified Rankin Scale (mRS) score at 3 months, determined using ordinal logistic regression (shift analysis), was the primary outcome.<br/>Results CA-O (n=149) was the most common etiology, followed by ICAS-O (n=63) and AT-O (n=49). Age, initial National Institutes of Health Stroke Scale (NIHSS) score, and rate of hemorrhagic transformation were significantly higher in patients with CA-O compared to AT-O and ICAS-O. The time from onset-to-recanalization was the shortest in the CA-O (356.0 minutes) groups, followed by the AT-O (847.0 minutes) and ICAS-O (944.0 minutes) groups. The rates of successful recanalization, mRS distribution, and favorable outcomes at 3 months (mRS 0–2; CA-O, 36.9%, AT-O, 53.1%; and ICAS-O, 41.3%) did not differ among the three groups. Baseline NIHSS score (odds ratio, 0.87; 95% confidence interval, 0.83 to 0.91) could independently predict a favorable shift in mRS distribution.<br/>Conclusions The functional outcomes of ICAS-O and AT-O were similar to those of CA-O, despite the delay in symptom onset-to-recanalization, suggesting that the therapeutic time window may be extended in these patients.

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Section: Introductionmentioning

confidence: 99%

Endovascular Treatment in Patients with Cerebral Artery Occlusion of Three Different Etiologies

Lee

Suh

et al. 2020

J Stroke

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“…Currently, mechanical thrombectomy (MT) is recommended as primary treatment for MCA and carotid artery occlusion [22,23]. Because of its rarity, there are few studies of MT in ACA occlusion.…”

Section: Resultsmentioning

confidence: 99%

Clinical prognosis of isolated anterior cerebral artery territory infarction: A retrospective study

Park

Jeong

Lee

et al. 2021

Preprint

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Background Isolated anterior cerebral artery territory (ACA) infarction is a rare phenomenon and had known to have distinctive clinical features. Little is known about the clinical prognosis of isolated ACA territory infarction with associated factors and its impact on dwelling and job status. We investigated the short- and long-term outcomes and associated factors involved in the development of the distinctive symptoms of anterior cerebral artery (ACA) territory infarction. Methods This retrospective study in a prospective cohort of acute ischaemic stroke patients included consecutively enrolled patients with isolated ACA territory infarction. We investigated the functional status using the modified Rankin scale (mRS) score at discharge, three months post-discharge, and one-year post-discharge. We also investigated the occlusion site of the ACA (proximal vs. distal); presence of distinctive symptoms of ACA territory infarction including behaviour changes, indifference, aphasia, and urinary incontinence; and the effect of these symptoms on dwelling and job status one year after discharge. Results From April 2014 to March 2019, 47 patients with isolated ACA territory infarction were included. Twenty-nine patients (61.7%) had good outcomes (mRS ≤ 2) at discharge; however, the mRS score increased at three months (40; 85.1%, p < 0.001) and one year (41; 87.2%) post-discharge. Occlusion of the ACA proximal segment was independently associated with the development of distinctive symptoms (adjusted odds ratio, 17.68; 95% confidence interval: 2.55–122.56, p < 0.05). Twenty-one (48.8%) patients with good outcomes at one year experienced a change in dwelling status and job loss; 20 (95.2%) of them had distinctive ACA territory symptoms with proximal ACA occlusion. Conclusions Short- and long-term outcomes of isolated ACA territory infarction were favourable. However, proximal segment occlusion was associated with the development of distinctive symptoms, possibly related to future dwelling and job status.

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“…Currently, mechanical thrombectomy (MT) is recommended as primary treatment for MCA and carotid artery occlusion [ 23 , 24 ]. Owing to its rarity, there are few studies on MT in ACA occlusion; the average A2 and A3 diameters were > 2.0 mm [ 25 ].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Clinical prognosis of isolated anterior cerebral artery territory infarction: a retrospective study

et al. 2021

View full text Add to dashboard Cite

Background Isolated anterior cerebral artery territory (ACA) infarction is a rare phenomenon, and is known to have distinctive clinical features. Little is known regarding the clinical prognosis of isolated ACA territory infarction with associated factors, and its impact on dwelling and job status. We investigated the short- and long-term outcomes of anterior cerebral artery (ACA) territory infarction, and the associated factors involved in the development of the distinctive symptoms. Methods This retrospective study in a prospective cohort of acute ischaemic stroke patients included consecutively enrolled patients with isolated ACA territory infarction. We investigated the functional status using the modified Rankin scale (mRS) score at discharge, three months’ post-discharge, and one-year post-discharge. We also investigated the occlusion site of the ACA (proximal vs. distal); presence of distinctive symptoms of ACA territory infarction including behaviour changes, indifference, aphasia, and urinary incontinence; and the effect of these symptoms on dwelling and job status one year after discharge. Results Between April 2014 and March 2019, 47 patients with isolated ACA territory infarction were included. Twenty-nine patients (61.7 %) had good outcomes (mRS ≤ 2) at discharge; however, the mRS score increased at three months (40; 85.1 %, p < 0.001) and one year (41; 87.2 %) post-discharge. Occlusion of the ACA proximal segment was independently associated with the development of distinctive symptoms (adjusted odds ratio, 17.68; 95 % confidence interval: 2.55–122.56, p < 0.05). Twenty-one (48.8 %) patients with good outcomes at one year experienced a change in dwelling status and job loss; 20 (95.2 %) of them had distinctive ACA territory symptoms with proximal ACA occlusion. Conclusions Short- and long-term outcomes of isolated ACA territory infarction were favourable. However, proximal segment occlusion was associated with the development of distinctive symptoms, possibly related to future dwelling and job status.

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2019 Update of the Korean Clinical Practice Guidelines of Stroke for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke

Cited by 47 publications

References 37 publications

Endovascular Treatment in Patients with Cerebral Artery Occlusion of Three Different Etiologies

Endovascular Treatment in Patients with Cerebral Artery Occlusion of Three Different Etiologies

Clinical prognosis of isolated anterior cerebral artery territory infarction: A retrospective study

Clinical prognosis of isolated anterior cerebral artery territory infarction: a retrospective study

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