Outcome of patients with multivessel occlusion stroke after endovascular treatment
INTRODUCTION: Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).
PATIENTS AND METHODS: We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014-November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.
RESULTS: Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25-0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24-3.57).
DISCUSSION AND CONCLUSION: MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
European stroke journal - (2023) vom: 15. Dez., Seite 23969873231216811 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
LeCouffe, Natalie E [VerfasserIn] |
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| Links: |
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| Themen: |
Endovascular treatment |
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| Anmerkungen: |
Date Revised 16.12.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1177/23969873231216811 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365934607 |
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| 100 | 1 | |a LeCouffe, Natalie E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcome of patients with multivessel occlusion stroke after endovascular treatment |
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| 500 | |a Date Revised 16.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
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| 520 | |a INTRODUCTION: Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT) | ||
| 520 | |a PATIENTS AND METHODS: We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014-November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality | ||
| 520 | |a RESULTS: Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% ⩾3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25-0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24-3.57) | ||
| 520 | |a DISCUSSION AND CONCLUSION: MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Endovascular treatment | |
| 650 | 4 | |a multivessel occlusions | |
| 650 | 4 | |a stroke | |
| 700 | 1 | |a Treurniet, Kilian M |e verfasserin |4 aut | |
| 700 | 1 | |a Kappelhof, Manon |e verfasserin |4 aut | |
| 700 | 1 | |a Jansen, Ivo Gh |e verfasserin |4 aut | |
| 700 | 1 | |a Boers, Merel |e verfasserin |4 aut | |
| 700 | 1 | |a Marquering, Henk A |e verfasserin |4 aut | |
| 700 | 1 | |a Beenen, Ludo Fm |e verfasserin |4 aut | |
| 700 | 1 | |a Boiten, Jelis |e verfasserin |4 aut | |
| 700 | 1 | |a van Zwam, Wim H |e verfasserin |4 aut | |
| 700 | 1 | |a Yo, Lonneke Sf |e verfasserin |4 aut | |
| 700 | 1 | |a Majoie, Charles Blm |e verfasserin |4 aut | |
| 700 | 1 | |a Roos, Yvo Bwem |e verfasserin |4 aut | |
| 700 | 1 | |a Emmer, Bart J |e verfasserin |4 aut | |
| 700 | 1 | |a Coutinho, Jonathan M |e verfasserin |4 aut | |
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