Long-term outcome changes after mechanical thrombectomy for anterior circulation acute ischemic stroke

Background and purpose Mechanical thrombectomy (MT) improves early clinical outcome in patients with acute ischemic stroke but insights on determinants of long-term outcome after MT treatment are scarce. Methods Data from stroke patients with anterior circulation large vessel occlusion of a prospect...

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Bibliographic Details
Published in:Journal of neurology 2020-04, Vol.267 (4), p.1026-1034
Main Authors: Fuhrer, Hannah, Forner, Lisa, Pruellage, Pascal, Weber, Susanne, Beume, Lena-Alexandra, Schacht, Hannes, Egger, Karl, Bardutzky, Juergen, Weiller, Cornelius, Urbach, Horst, Niesen, Wolf-Dirk, Meckel, Stephan
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cerebral Arterial Diseases - complications
Cerebral Arterial Diseases - therapy
Female
Hemispheric laterality
Humans
Ischemia
Ischemic Stroke - etiology
Ischemic Stroke - therapy
Longitudinal Studies
Male
Mechanical Thrombolysis - statistics & numerical data
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuroradiology
Neurosciences
Occlusion
Original Communication
Outcome Assessment, Health Care - statistics & numerical data
Patients
Registries
Rehabilitation
Stroke
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Summary:Background and purpose Mechanical thrombectomy (MT) improves early clinical outcome in patients with acute ischemic stroke but insights on determinants of long-term outcome after MT treatment are scarce. Methods Data from stroke patients with anterior circulation large vessel occlusion of a prospective MT registry (01/2014–06/2017) of a large comprehensive stroke center were analyzed regarding clinical outcome between short- (3 months) and long-term (12 months) assessment reflected by a change of modified Rankin scores (∆mRS). Secondary endpoints included favorable long-term outcome (mRS 0–2). Multi-variable regression analysis was performed to identify determinants of outcome changes and favorable outcome at long term. Results Of 264 patients included, 42.0% showed a favorable long-term outcome. Longitudinal analysis found that some individuals still improved, but no overall mRS difference between short and long-term follow-up was detected [∆mRS − 0.004 (95% CI − 0.020; 0.013); p  = 0.672]. Right hemispheric stroke [∆mRS 0.286 (0.011; 0.561); p  = 0.043] and high NIHSS at discharge [∆mRS, 0.039 (0.004; 0.074); p  = 0.029] were associated with a longitudinal mRS decline. Favorable long-term outcome was associated with successful recanalization ( p  
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-019-09670-w