Factors Associated with Poor Outcomes in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke due to Large-Vessel Occlusion in Acute Anterior Circulation: A Retrospective Study

Zhang, Yihe; Shi, Mingchao; Wang, Zhongxiu; Li, Chao; Sun, Mengyao; Zhou, Jie; Zhang, Wenbin; Huo, Longwen; Wang, Shouchun

doi:10.1016/j.wneu.2021.02.064

Cited by 11 publications

(11 citation statements)

References 38 publications

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“…To date, several independent factors have been identified by some authors which reportedly worsen the functional status of patients undergoing MT for stroke. These include older age, low ASPECTS scores, and high NIHSS scores [12][13][14]17,18]. In terms of the importance of age and neurological status, we have confirmed the reports of other authors; we have also gained more experience concerning the influence of a patient's clinical profile on the outcome of endovascular therapy and their post-stroke functional status in the acute period of stroke.…”

Section: Discussionsupporting

confidence: 84%

“…To date, inconsistent results evaluating the effect of DM and AF on MT outcomes have been published [13,15]. AF is a common cause of LVO that necessitates endovascular treatment [9,[20][21][22].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, attempts are being made to identify the parameters to determine the outcome of endovascular therapy in acute stroke patients. The most common findings are age, the patients' neurological status during the ultra-acute stage of stroke, and the ASPECTS score [12][13][14]. Atrial fibrillation, diabetes, previous exposure to anticoagulation, the morphotic parameters of blood, and inflammatory parameters all have a conflicting status in several studies [12,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Non-Clinical Determinants of the Effect of Mechanical Thrombectomy and Post-Stroke Functional Status of Patients in Short and Long-Term Follow-Up

Lasek–Bal

Binek

Żak

et al. 2021

JCM

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To date, inconsistent results evaluating the effect of parameters on mechanical thrombectomy (MT) outcomes in stroke-patients have been published. This study aimed to identify the key parameters for functional status after MT in stroke-patients in short and long-term follow-up. Method: The study analysis focused on the relevance of selected clinical and non-clinical parameters to the functional status of the patients after MT. Results: 417 stroke-patients (mean age 67.8 ± 13.2 years) were qualified. Atrial fibrillation, and leukocytosis were significant for the neurological status on the first day of stroke (p = 0.036, and p = 0.0004, respectively). The parameters with the strongest effect on the functional status on day 10 were: age (p = 0.009), NIHSS (p = 0.002), hyperglycemia (p = 0.009), the result in TICI (p = 0.046), and first pass effect (p = 0.043). The parameters with the strongest effect on the functional status on day 365 were: age and NIHSS on the first day of stroke (p = 0.0002 and 0.002, respectively). Leukocytosis and the neurological status at baseline were key parameters associated with ICB after MT (p = 0.007 and p = 0.003, respectively). Conclusions: Age and neurological status in the ultra-acute phase of stroke are crucial for the functional status in short and long-term observations of patients treated with mechanical thrombectomy. Atrial fibrillation, hyperglycemia, and inflammatory state are relevant to the short-term post-stroke functional status. First pass effect and the degree of post-interventional reperfusion are important technical parameters to the short-term functional status. Neurological status and white blood count during the acute phase are associated with a high rate of post-procedural intracranial bleeding.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and Non-Clinical Determinants of the Effect of Mechanical Thrombectomy and Post-Stroke Functional Status of Patients in Short and Long-Term Follow-Up

Lasek–Bal

Binek

Żak

et al. 2021

JCM

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“…The relevant literature reports multiple examples of clinical, biological, biochemical, and radiological factors with potential relevance to the prognosis for ischaemic stroke patients treated with mechanical thrombectomy [22,23]. The factors associated with a poorer prognosis following thrombectomy include: age, comorbitidies (HA, DM), previous stroke, stroke severity, the Alberta Stroke Program Early CT Score (ASPECTS), ischemic core volume, mismatch of ischemic core and hypoperfusion volume, white matter lesions, the location of the occlusion, collateral flow status and neutrophil lymphocyte ratio [5][6][7][8]24,25].…”

Section: Discussionmentioning

confidence: 99%

“…The unfavorable prognosis parameters identified in the subpopulation of patients treated by endovascular therapy due to stroke include: old age, diabetes mellitus, admission stroke severity, poor neurological status on the first day of stroke, and low Alberta Stroke Program Early CT Score (ASPECTS) [6][7][8][9]. Some of the potential factors determining the prognosis in stroke patients after thrombectomy also include chronic inflammation.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Role of Chronic Rhinosinusitis in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy

Puz

Stryjewska-Makuch

Żak

et al. 2021

JCM

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Background: The aim of the study was to assess the relevance of chronic rhinosinusitis (CRS) CT features to the efficacy of mechanical thrombectomy (MT) in patients with acute ischemic stroke. Methods: This study included 311 patients qualified for MT in whom the CRS features were assessed based on a CT scan, according to the Lund-Mackay (L-M) score. Clinical, inflammatory parameters, patients neurological (NIHSS) and functional status (mRS), and recanalisation efficacy (TICI) were compared between patients with mild lesions (L-M score 0–3 points)-group 1, and patients with more severe lesions (L–M score 4–24)-group 2. Results: There was a significant difference in the NIHSS on day seven after stroke onset-10 points in group 1 and 14 points in group 2, p = 0.02. NIHSS ≤ 6 points on day seven was found in 41.9% of patients in group 1, and in 27.5% in group 2, p = 0.042. There were no significant differences in mRS score and in the TICI score. L-M score, lipid abnormalities and CRP were factors associated with NIHSS ≥ 7 points on day 7. Conclusions: The CT features of CRS may be used as a prognostic tool for early prognosis assessment in stroke patients.

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Safety and efficacy of intravenous thrombolysis in patients with acute ischemic stroke taking direct oral anticoagulants prior to stroke: a meta-analysis

et al. 2023

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Factors Associated with Poor Outcomes in Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke due to Large-Vessel Occlusion in Acute Anterior Circulation: A Retrospective Study

Cited by 11 publications

References 38 publications

Clinical and Non-Clinical Determinants of the Effect of Mechanical Thrombectomy and Post-Stroke Functional Status of Patients in Short and Long-Term Follow-Up

Clinical and Non-Clinical Determinants of the Effect of Mechanical Thrombectomy and Post-Stroke Functional Status of Patients in Short and Long-Term Follow-Up

Prognostic Role of Chronic Rhinosinusitis in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy

Safety and efficacy of intravenous thrombolysis in patients with acute ischemic stroke taking direct oral anticoagulants prior to stroke: a meta-analysis

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