Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China
Abstract Background We aimed to assess the safety and efficacy of endovascular treatment (EVT) in patients with anterior circulation emergent large vessel occlusion (ELVO) beyond 6 h from symptom onset in a real-world cohort of patients in China. Methods We retrospectively examined 305 patients with...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-021-02122-x |
| _version_ | 1818915419408302080 |
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| author | Qing Huang Mengmeng Gu Junshan Zhou Teng Jiang Hongchao Shi Xiangliang Chen Yingdong Zhang |
| author_facet | Qing Huang Mengmeng Gu Junshan Zhou Teng Jiang Hongchao Shi Xiangliang Chen Yingdong Zhang |
| author_sort | Qing Huang |
| collection | DOAJ |
| description | Abstract Background We aimed to assess the safety and efficacy of endovascular treatment (EVT) in patients with anterior circulation emergent large vessel occlusion (ELVO) beyond 6 h from symptom onset in a real-world cohort of patients in China. Methods We retrospectively examined 305 patients with anterior circulation ELVO treated with EVT. Patients were divided into two groups: treated with known onset within 6 h (n = 238) and beyond 6 h (n = 67). Multivariable logistic regression and ordinal shift analyses were used to evaluate the associations between onset-to-groin puncture time and safety and efficacy outcomes. Results Treatment beyond 6 h was not associated with symptomatic intracranial hemorrhage within 48 h (sICH; odds ratio [OR] 2.03, 95% confidence interval [CI] 0.48–8.57, p = 0.334), in-hospital mortality (OR 1.95, 95% CI 0.48–7.91, p = 0.348), successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b or 3; OR 0.73, 95% CI 0.31–1.73, p = 0.470), favorable functional outcome (modified Rankin Scale score 0–2; OR 0.55, 95% CI 0.25–1.23, p = 0.145), and functional improvement (modified Rankin Scale shift by 1-point decrease; common OR 0.80, 95%CI 0.45–1.42, p = 0.450) at 3 months compared with treatment within 6 h. Futher interaction analysis showed that stroke etiology did not modify the associations between onset-to-groin puncture time and outcomes (p > 0.05). Conclusions In this real-world study, after careful assessment, EVT beyond 6 h from known stroke onset was safe, effective and had comparable short-term outcomes to EVT within 6 h. |
| first_indexed | 2024-12-20T00:01:59Z |
| format | Article |
| id | doaj.art-075976fefa094964b9b75a0ae6ca3b70 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-20T00:01:59Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-075976fefa094964b9b75a0ae6ca3b702022-12-21T20:00:47ZengBMCBMC Neurology1471-23772021-02-012111810.1186/s12883-021-02122-xEndovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in ChinaQing Huang0Mengmeng Gu1Junshan Zhou2Teng Jiang3Hongchao Shi4Xiangliang Chen5Yingdong Zhang6Department of Neurology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Neurology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Neurology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Neurology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Neurology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Neurology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Neurology, Nanjing First Hospital, Nanjing Medical UniversityAbstract Background We aimed to assess the safety and efficacy of endovascular treatment (EVT) in patients with anterior circulation emergent large vessel occlusion (ELVO) beyond 6 h from symptom onset in a real-world cohort of patients in China. Methods We retrospectively examined 305 patients with anterior circulation ELVO treated with EVT. Patients were divided into two groups: treated with known onset within 6 h (n = 238) and beyond 6 h (n = 67). Multivariable logistic regression and ordinal shift analyses were used to evaluate the associations between onset-to-groin puncture time and safety and efficacy outcomes. Results Treatment beyond 6 h was not associated with symptomatic intracranial hemorrhage within 48 h (sICH; odds ratio [OR] 2.03, 95% confidence interval [CI] 0.48–8.57, p = 0.334), in-hospital mortality (OR 1.95, 95% CI 0.48–7.91, p = 0.348), successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b or 3; OR 0.73, 95% CI 0.31–1.73, p = 0.470), favorable functional outcome (modified Rankin Scale score 0–2; OR 0.55, 95% CI 0.25–1.23, p = 0.145), and functional improvement (modified Rankin Scale shift by 1-point decrease; common OR 0.80, 95%CI 0.45–1.42, p = 0.450) at 3 months compared with treatment within 6 h. Futher interaction analysis showed that stroke etiology did not modify the associations between onset-to-groin puncture time and outcomes (p > 0.05). Conclusions In this real-world study, after careful assessment, EVT beyond 6 h from known stroke onset was safe, effective and had comparable short-term outcomes to EVT within 6 h.https://doi.org/10.1186/s12883-021-02122-xEndovascular treatmentTime windowRecanalizationSymptomatic intracranial hemorrhageFunctional outcome |
| spellingShingle | Qing Huang Mengmeng Gu Junshan Zhou Teng Jiang Hongchao Shi Xiangliang Chen Yingdong Zhang Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China BMC Neurology Endovascular treatment Time window Recanalization Symptomatic intracranial hemorrhage Functional outcome |
| title | Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China |
| title_full | Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China |
| title_fullStr | Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China |
| title_full_unstemmed | Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China |
| title_short | Endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours: a real-world study in China |
| title_sort | endovascular treatment of acute ischemic stroke due to anterior circulation large vessel occlusion beyond 6 hours a real world study in china |
| topic | Endovascular treatment Time window Recanalization Symptomatic intracranial hemorrhage Functional outcome |
| url | https://doi.org/10.1186/s12883-021-02122-x |
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