Arterial diameter and the gender disparity in stroke thrombectomy outcomes

Davison, Mark A.; Ouyang, Bo; Keppetipola, Kavantissa M.; Chen, Michael

doi:10.1136/neurintsurg-2017-013697

Cited by 24 publications

(18 citation statements)

References 29 publications

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“…Our findings also add to the literature by demonstrating sex differences in outcomes after mechanical thrombectomy in a non-clinical trial population and are thus potentially generalizable to other populations of patients with LVOs treated with thrombectomy at other geographic locations and institutions. Of note, one previous study of sex differences in outcomes after thrombectomy suggests that smaller intracerebral vessel diameter could be a contributor to such differences 11. In this particular study, both the ICA and MCA were smaller in females than males, but neither sex nor vessel diameter were significant predictors of outcome in multivariate analyses 11.…”

Section: Discussioncontrasting

confidence: 52%

“…Of note, one previous study of sex differences in outcomes after thrombectomy suggests that smaller intracerebral vessel diameter could be a contributor to such differences 11. In this particular study, both the ICA and MCA were smaller in females than males, but neither sex nor vessel diameter were significant predictors of outcome in multivariate analyses 11. The study, however, was underpowered to detect outcome differences by sex or vessel diameter 11…”

Section: Discussionmentioning

confidence: 54%

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Sex differences in 90-day outcomes after mechanical thrombectomy for acute ischemic stroke

Madsen

DeCroce-Movson

Hemendinger

et al. 2018

J NeuroIntervent Surg

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 54%

Sex differences in 90-day outcomes after mechanical thrombectomy for acute ischemic stroke

Madsen

DeCroce-Movson

Hemendinger

et al. 2018

J NeuroIntervent Surg

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“…Previous studies reported that females consistently fare worse than males following MT for large vessel ischemic stroke [ 16 , 17 ]. One of the possible reasons is that males have larger cerebral arterial diameters than females, which may improve the odds for favorable clinical outcomes [ 18 ]. Serum creatinine is widely used as an indicator of renal function, and impaired renal function is also associated with long-term mortality and poor prognosis after stroke [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Nomogram to predict 3-month unfavorable outcome after thrombectomy for stroke

et al. 2022

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Background Mechanical thrombectomy (MT) is an effective treatment for large-vessel occlusion in acute ischemic stroke, however, only some revascularized patients have a good prognosis. For stroke patients undergoing MT, predicting the risk of unfavorable outcomes and adjusting the treatment strategies accordingly can greatly improve prognosis. Therefore, we aimed to develop and validate a nomogram that can predict 3-month unfavorable outcomes for individual stroke patient treated with MT. Methods We analyzed 258 patients with acute ischemic stroke who underwent MT from January 2018 to February 2021. The primary outcome was a 3-month unfavorable outcome, assessed using the modified Rankin Scale (mRS), 3–6. A nomogram was generated based on a multivariable logistic model. We used the area under the receiver-operating characteristic curve to evaluate the discriminative performance and used the calibration curve and Spiegelhalter’s Z-test to assess the calibration performance of the risk prediction model. Results In our visual nomogram, gender (odds ratio [OR], 3.40; 95%CI, 1.54–7.54), collateral circulation (OR, 0.46; 95%CI, 0.28–0.76), postoperative mTICI (OR, 0.06; 95%CI, 0.01–0.50), stroke-associated pneumonia (OR, 5.76; 95%CI, 2.79–11.87), preoperative Na (OR, 0.82; 95%CI, 0.72–0.92) and creatinine (OR, 1.02; 95%CI, 1.01–1.03) remained independent predictors of 3-month unfavorable outcomes in stroke patients treated with MT. The area under the nomogram curve was 0.8791 with good calibration performance (P = 0.873 for the Spiegelhalter’s Z-test). Conclusions A novel nomogram consisting of gender, collateral circulation, postoperative mTICI, stroke-associated pneumonia, preoperative Na and creatinine can predict the 3-month unfavorable outcomes in stroke patients treated with MT.

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“…Previous studies reported that females consistently fare worse than males following MT for large vessel ischemic stroke [11,12]. One of the possible reasons is that males have larger cerebral arterial diameters than females, which may improve the odds for favorable clinical outcomes [13]. Serum creatinine is widely used as an indicator of renal function, and impaired renal function is also associated with long-term mortality and poor prognosis after stroke [14].…”

Section: Nomogram Variables Interpretationmentioning

confidence: 99%

A novel clinical nomogram for predicting 3-month unfavorable outcomes of stroke patients treated with mechanical thrombectomy

Zhang

Wang

Yang

et al. 2021

Preprint

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Background: Mechanical thrombectomy (MT) is an effective treatment for large-vessel occlusion in acute ischemic stroke, however, only some revascularized patients have a good prognosis. For stroke patients undergoing MT, predicting the risk of unfavorable outcomes and adjusting the treatment strategies accordingly can greatly improve prognosis. Therefore, we aimed to develop and validate a nomogram that can predict 3-month unfavorable outcomes for individual stroke patient treated with MT. Methods: We analyzed 238 patients with acute ischemic stroke who underwent MT from January 2018 to October 2020. The primary outcome was a 3-month unfavorable outcome, assessed using the modified Rankin Scale (mRS), 3-6. A nomogram was generated based on a multivariable logistic model. We used the area under the receiver-operating characteristic curve to evaluate the discriminative performance and used the calibration curve and Spiegelhalter’s Z-test to assess the calibration performance of the risk prediction model. Results: After multivariable logistic regression, six variables (gender, bridging therapy, postoperative mTICI, stroke-associated pneumonia, preoperative creatinine and Na) remained independent predictors of 3-month unfavorable outcomes in stroke patients treated with MT, thus forming a nomogram. The area under the nomogram curve was 0.848 with good calibration performance (P = 0.946 for the Spiegelhalter’s Z-test). Conclusions: A novel nomogram consisting of gender, bridging therapy, postoperative mTICI, stroke-associated pneumonia, preoperative creatinine and Na can predict the 3-month unfavorable outcomes in stroke patients treated with MT.

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Arterial diameter and the gender disparity in stroke thrombectomy outcomes

Cited by 24 publications

References 29 publications

Sex differences in 90-day outcomes after mechanical thrombectomy for acute ischemic stroke

Sex differences in 90-day outcomes after mechanical thrombectomy for acute ischemic stroke

Nomogram to predict 3-month unfavorable outcome after thrombectomy for stroke

A novel clinical nomogram for predicting 3-month unfavorable outcomes of stroke patients treated with mechanical thrombectomy

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