Predictor of 90-day functional outcome after mechanical thrombectomy for large vessel occlusion stroke: NIHSS score of 10 or less at 24 hours

Wirtz, Mirja M.; Hendrix, Philipp; Goren, Oded; Beckett, Lisa; Dicristina, Heather; Schirmer, Clemens M.; Dalal, Shamsher; Weiner, Gregory M.; Foreman, Paul M.; Zand, Ramin; Griessenauer, Christoph J.

doi:10.3171/2019.10.jns191991

Cited by 32 publications

(43 citation statements)

References 12 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%

“…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: Introductionmentioning

confidence: 99%

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 most susceptible regions of the brain to cerebral ischemia are the hippocampus and cortex, and data mining for circRNAs in the cortex is therefore valuable in establishing the mechanisms underlying damage and self-repair poststroke. A large number of studies have shown that the 24-hour time point is the most severe time point for nerve damage after cerebral ischemia and reperfusion injury [ 50 , 52 – 55 ]. We detected 24,858 circRNAs, among which 20,199 were novel and 4,659 were known.…”

Section: Discussionmentioning

confidence: 99%

Deep Sequencing of the Rat MCAO Cortexes Reveals Crucial circRNAs Involved in Early Stroke Events and Their Regulatory Networks

Wang

Yang

et al. 2021

Neural Plasticity

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Circular RNAs (circRNAs) are highly enriched in the central nervous system and significantly involved in a range of brain-related physiological and pathological processes. Ischemic stroke is a complex disorder caused by multiple factors; however, whether brain-derived circRNAs participate in the complex regulatory networks involved in stroke pathogenesis remains unknown. Here, we successfully constructed a cerebral ischemia-injury model of middle cerebral artery occlusion (MCAO) in male Sprague-Dawley rats. Preliminary qualitative and quantitative analyses of poststroke cortical circRNAs were performed through deep sequencing, and RT-PCR and qRT-PCR were used for validation. Of the 24,858 circRNAs expressed in the rat cerebral cortex, 294 circRNAs were differentially expressed in the ipsilateral cerebral cortex between the MCAO and sham rat groups. Cluster, GO, and KEGG analyses showed enrichments of these circRNAs and their host genes in numerous biological processes and pathways closely related to stroke. We selected 106 of the 294 circRNAs and constructed a circRNA-miRNA-mRNA interaction network comprising 577 sponge miRNAs and 696 target mRNAs. In total, 15 key potential circRNAs were predicted to be involved in the posttranscriptional regulation of a series of downstream target genes, which are widely implicated in poststroke processes, such as oxidative stress, apoptosis, inflammatory response, and nerve regeneration, through the competing endogenous RNA mechanism. Thus, circRNAs appear to be involved in multilevel actions that regulate the vast network of multiple mechanisms and events that occur after a stroke. These results provide novel insights into the complex pathophysiological mechanisms of stroke.

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“…The main outcome measures we sought at the vascular recanalization rate, the rate of incidence of adverse events, the rate of mortality within 90 days, preoperative and postoperative 7 days NIH Stroke Scale score, [ 19 , 20 ] postoperative 90 days Modified Rankin Scale score. [ 21 ]…”

Section: Methods and Analysismentioning

confidence: 99%

Efficacy and safety of mechanical thrombectomy for cardioembolic stroke

et al. 2021

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Background: Several randomized clinical trials have demonstrated the safety and efficiency of mechanical thrombectomy in the management of acute ischaemic stroke caused by larger vessel occlusion. According to the trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, acute ischaemic stroke can be divided into cardioembolic stroke and non-cardioembolic stroke. Previous studies have shown that mechanical thrombectomy in cardioembolic stroke with intracranial large artery occlusion has a poor prognosis. The reason may be that the old emboli are hard, making it difficult to remove. However, recent evidence shows that mechanical thrombectomy is also effective and safe in patients with cardioembolic stroke. Therefore, the aim of this study is to evaluate the efficacy and safety of mechanical thrombectomy for cardioembolic stroke. Methods: The electronic database, including PubMed, Cochrane Library, EMBASE, the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP database, and Wan-fang database, were thoroughly retrieved from inception to December 1, 2021, without language restrictions. All randomized controlled trials that evaluated the efficacy and safety of mechanical thrombectomy in the treatment of cardioembolic stroke will be included. Primary outcomes will include vascular recanalization rate and score scale. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by discussion among authors. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Dichotomous variables will be reported as risk ratio or odds ratio with 95% confidence intervals and continuous variables will be summarized as mean difference or standard mean difference with 95% confidence intervals. Results: This review will be to assess the efficacy and safety of mechanical thrombectomy for cardioembolic stroke. Conclusions: The results of our findings may be helpful for clinicians and health professionals to re-examine the clinical decision-making in the treatment of cardioembolic stroke, promising way for treatment of patients with cardioembolic stroke. Systematic review registration number: INPLASY2020120035

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Predictor of 90-day functional outcome after mechanical thrombectomy for large vessel occlusion stroke: NIHSS score of 10 or less at 24 hours

Cited by 32 publications

References 12 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

Deep Sequencing of the Rat MCAO Cortexes Reveals Crucial circRNAs Involved in Early Stroke Events and Their Regulatory Networks

Efficacy and safety of mechanical thrombectomy for cardioembolic stroke

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