Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real‐world multicenter experience

Yeo, Leonard L.L.; Chen, Vanessa Hui En; Leow, Aloysius Sheng‐Ting; Meyer, Lukas; Fiehler, Jens; Tu, Tian Ming; Tham, Carol Huilian; Sia, Ching‐Hui; Jamous, Ala; Behme, Daniel; Kastrup, Andreas; Papanagiotou, Panagiotis; Styczen, Hanna; Forsting, Michael; Lee, Tsong‐Hai; Chu, Chan-Lin; Fischer, Sebastian; Maus, Volker; Abdullayev, Nuran; Kabbasch, Christoph; Mönch, Sebastian; Maegerlein, Christian; Arnberg, Fabian; Andersson, Tommy; Holmin, Staffan; Teoh, Hock-Luen; Paliwal, Prakash; Ahmad, Aftab; Gopinathan, Anil; Yang, Chao; Seet, Raymond C.S.; Chan, Bernard; Sharma, Vijay K.; Tan, Benjamin Yong‐Qiang

doi:10.1111/ene.14899

Cited by 13 publications

(19 citation statements)

References 39 publications

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“…Young patients were associated with better clinical outcomes, which was consistent with existing literature [ 10 , 11 , 28 , 29 ]. For example, 40.78% (62/152) of young patients with stroke achieved favorable outcomes at 90 days, resulting in a difference of 11.43% (95% CI 2.65–20.22) compared with old patients.…”

Section: Discussionsupporting

confidence: 91%

“…3 ) also indicated that young adults had a better prognosis. In a real-world multicenter experience, 66.20% of young patients (aged < 50 years) who underwent EVT because of large artery occlusion achieved favorable outcomes and 4.70% of the patients died [ 11 ]. For these patients, the rate of favorable clinical outcome (mRS 0–2) at 3 months was higher (61.00% vs. 38.80%) and mortality was lower (6.80% vs. 31.90%) than in old patients according to the MR CLEAN Registry [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Young patients (aged \ 50 years) with stroke accounted for up to 19% in the BASICS registry study [8] and up to 11.3% in the BASICS trial [6] of all acute BAO. Large vessel occlusion in young patients is often accompanied by fewer vascular risk factors and inapparent pathological changes in vascular structures, including fewer tortuous vessels, atherosclerosis, and calcification [9][10][11][12]. Thus, the causes of vessel occlusion and responses to EVT in young patients are different from those of elderly patients.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Endovascular Therapy in Young Patients with Acute Basilar Artery Occlusion: A Substudy of BASILAR Registry Study

Liu

et al. 2022

Neurol Ther

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Introduction This study aimed to investigate clinical outcomes in young patients with basilar artery occlusion (BAO) receiving endovascular therapy (EVT). Methods Consecutive patients with BAO within 24 h who underwent EVT from the BASILAR Registry study were enrolled. We compared clinical outcomes of young patients (aged 18–55 years) with older patients (aged > 55 years) with stroke due to BAO at 90 days and 1 year after EVT. The primary and secondary outcomes were improvement in modified Rankin scale scores (mRS) at 90 days and either favorable (mRS 0–3) or mortality at 90 days, respectively. Results A total of 646 patients were included, of which 152 (23.53%) were aged 18–55 years. Dyslipidemia (42.11% vs. 30.36%, p = 0.007) and good collateral circulation (60.52% vs. 46.35%, p = 0.002) were more frequent in young patients than older. Stroke etiologies in young patients included large artery atherosclerosis (67.11%), cardioembolism (15.13%), and vessel dissection (5.26%). Young patients were associated with better prognosis (mRS: adjusted odds ratio (aOR) 1.73; 95% confidence interval [CI] 1.21–2.48; mRS 0–3: aOR 1.60; 95% CI 1.01–2.54; mortality: aOR 0.60; 95% CI 0.38–0.93) at 90 days. Baseline National Institutes of Health Stroke Scale (NIHSS) score, posterior circulation Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS), and sex were independent predictors of clinical outcomes of young patients at 90 days after EVT. Conclusion Young patients with BAO had better clinical outcomes after EVT than old patients. Predictors of clinical outcomes in young patients undergoing EVT included baseline NIHSS score, pc-ASPECTS, and sex. Trial Registration Clinical Trial Registration-URL: ChiCTR180001475 ( www.chictr.org.cn ). Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00372-6.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Endovascular Therapy in Young Patients with Acute Basilar Artery Occlusion: A Substudy of BASILAR Registry Study

Liu

et al. 2022

Neurol Ther

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“…Arterial dissection was detected in 17.8% of our patient cohort, and did not significantly differ between young female and male AIS patients. This percentage lies within the range of 16% and 21.5% reported in AIS patients under 50 years of age undergoing MT in the MR CLEAN Registry Study and in a recently published multicenter cohort study, respectively [ 7 , 8 ].…”

Section: Discussionsupporting

confidence: 69%

Sex differences in etiology and short-term outcome in young ischemic stroke patients receiving mechanical thrombectomy

Weber

Winezki

Katsanos

et al. 2022

Neurol. Res. Pract.

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Background Although there are well known sex differences in older patients with ischemic stroke receiving acute reperfusion treatments, there is paucity of data in younger patients. Methods We investigated sex-related differences in clinical presentation, stroke etiology and short-term outcomes in consecutive young patients with acute ischemic stroke (AIS) below the age of 50 years receiving mechanical thrombectomy (MT) between January 2011 and May 2021 in a tertiary stroke center. Results We identified a total of 202 young ischemic stroke patients with MT, with 51% being female. Young female AIS patients were significantly younger (39 ± 8 vs. 43 ± 7 years, p < 0.001), and presented with a trend for more severe stroke on admission (median NIHSS 12 vs. 9, p = 0.065), compared to males, respectively. Young female AIS patients had higher rates of embolic strokes of determined or undetermined sources in the anterior circulation, while young male AIS patients suffered more often strokes of arterio-arterial embolism. Complete reperfusion (TICI score 3) was achieved significantly less often in young female AIS patients (69% vs. 83%, p = 0.006), and in-hospital mortality was 2-times higher (5% vs. 2%, p = 0.271) compared to males. Conclusions Young female AIS patients receiving MT have higher rates of severe embolic strokes and less often complete reperfusion due to different occlusion sites and stroke etiology compared to males.

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“…We recently read the original article by Leonard Leong-Litt Yeo et al [1], published in the European Journal of Neurology. Their study enrolled 275 patients with acute ischemic stroke, aged ≤50 years, who underwent endovascular thrombectomy in 10 comprehensive stroke centers across four different countries.…”

Section: E T T E R S T O T H E E D I T O R Younger Adults and Endovas...mentioning

confidence: 99%

Younger adults and endovascular thrombectomy

Gong

Peng

2021

Euro J of Neurology

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Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real‐world multicenter experience

Abstract: are co-first authors.

Cited by 13 publications

References 39 publications

Outcomes of Endovascular Therapy in Young Patients with Acute Basilar Artery Occlusion: A Substudy of BASILAR Registry Study

Outcomes of Endovascular Therapy in Young Patients with Acute Basilar Artery Occlusion: A Substudy of BASILAR Registry Study

Sex differences in etiology and short-term outcome in young ischemic stroke patients receiving mechanical thrombectomy

Younger adults and endovascular thrombectomy

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