Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry
Objectives To investigate the safety and efficacy of endovascular treatment (EVT) for acute medium vessel occlusion (MeVO) in the anterior circulation and to explore the independent predictors of the 90-day good outcome for such patients.Methods Data from ANGEL-ACT Registry were analysed in our stud...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
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| Series: | Stroke and Vascular Neurology |
| Online Access: | https://svn.bmj.com/content/early/2022/08/31/svn-2022-001561.full |
| _version_ | 1798004617789833216 |
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| author | Ning Ma Dapeng Mo Feng Gao Zhongrong Miao Xiaochuan Huo Anxin Wang Raynald Baixue Jia Gaoting Ma Xu Tong Dapeng Sun |
| author_facet | Ning Ma Dapeng Mo Feng Gao Zhongrong Miao Xiaochuan Huo Anxin Wang Raynald Baixue Jia Gaoting Ma Xu Tong Dapeng Sun |
| author_sort | Ning Ma |
| collection | DOAJ |
| description | Objectives To investigate the safety and efficacy of endovascular treatment (EVT) for acute medium vessel occlusion (MeVO) in the anterior circulation and to explore the independent predictors of the 90-day good outcome for such patients.Methods Data from ANGEL-ACT Registry were analysed in our study. The outcomes, such as the modified Rankin Scale (mRS) at 90 days, successful recanalisation rate and symptomatic intracranial haemorrhage (SICH) rate, were compared between MeVO and acute large vessel occlusions (LVO). Then, the independent predictors of the good outcome at 90 days in MeVO patients were determined by the logistic regression analyses.Results We included 1032 subjects in the analysis, of which, 147 were MeVO and 885 were LVO. mRS at 90 days distribution (3 (0–4) vs 3 (0–5), common odds ratio (OR) =1.00, 95% confidence interval (CI) 0.73 to 1.38, p=0.994), SICH rate (4.8% vs 8.9%; OR=0.59, 95% CI 0.26 to 1.34, p=0.205) and successful recanalisation rate (89.8% vs 89.7%; OR=1.00 95% CI 0.51 to 1.93, p=0.992) were similar between the MeVO and LVO groups after adjusting for the confounders. We identified that baseline neutrophil-to-lymphocyte ratio ≤4.1 (OR=2.13, 95% CI 1.14 to 3.99, p=0.019), baseline National Institutes of Health Stroke Scale ≤14 (OR=1.96, 95% CI 1.02 to 3.80, p=0.045) and mechanical thrombectomy passes ≤1 (OR=2.16, 95% CI 1.14 to 4.11, p=0.021) were independent predictors of the 90-day good outcome in MeVO patients undergoing EVT.Conclusions Patients with MeVO achieved similar 90-day mRS, SICH rate and successful recanalisation rate after EVT compared with patients with LVO. Several independent predictors of 90-day good outcome in MeVO patients undergoing EVT were determined, which should be highly considered in MeVO stroke management. |
| first_indexed | 2024-04-11T12:26:29Z |
| format | Article |
| id | doaj.art-0cbfd27164934cc49c488cfcf8d8bbb3 |
| institution | Directory Open Access Journal |
| issn | 2059-8696 |
| language | English |
| last_indexed | 2024-04-11T12:26:29Z |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Stroke and Vascular Neurology |
| spelling | doaj.art-0cbfd27164934cc49c488cfcf8d8bbb32022-12-22T04:23:55ZengBMJ Publishing GroupStroke and Vascular Neurology2059-869610.1136/svn-2022-001561Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registryNing Ma0Dapeng Mo1Feng Gao2Zhongrong Miao3Xiaochuan Huo4Anxin Wang5Raynald 6Baixue Jia7Gaoting Ma8Xu Tong9Dapeng Sun10Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China1 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China2 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China1 Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaNeurointervention center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaObjectives To investigate the safety and efficacy of endovascular treatment (EVT) for acute medium vessel occlusion (MeVO) in the anterior circulation and to explore the independent predictors of the 90-day good outcome for such patients.Methods Data from ANGEL-ACT Registry were analysed in our study. The outcomes, such as the modified Rankin Scale (mRS) at 90 days, successful recanalisation rate and symptomatic intracranial haemorrhage (SICH) rate, were compared between MeVO and acute large vessel occlusions (LVO). Then, the independent predictors of the good outcome at 90 days in MeVO patients were determined by the logistic regression analyses.Results We included 1032 subjects in the analysis, of which, 147 were MeVO and 885 were LVO. mRS at 90 days distribution (3 (0–4) vs 3 (0–5), common odds ratio (OR) =1.00, 95% confidence interval (CI) 0.73 to 1.38, p=0.994), SICH rate (4.8% vs 8.9%; OR=0.59, 95% CI 0.26 to 1.34, p=0.205) and successful recanalisation rate (89.8% vs 89.7%; OR=1.00 95% CI 0.51 to 1.93, p=0.992) were similar between the MeVO and LVO groups after adjusting for the confounders. We identified that baseline neutrophil-to-lymphocyte ratio ≤4.1 (OR=2.13, 95% CI 1.14 to 3.99, p=0.019), baseline National Institutes of Health Stroke Scale ≤14 (OR=1.96, 95% CI 1.02 to 3.80, p=0.045) and mechanical thrombectomy passes ≤1 (OR=2.16, 95% CI 1.14 to 4.11, p=0.021) were independent predictors of the 90-day good outcome in MeVO patients undergoing EVT.Conclusions Patients with MeVO achieved similar 90-day mRS, SICH rate and successful recanalisation rate after EVT compared with patients with LVO. Several independent predictors of 90-day good outcome in MeVO patients undergoing EVT were determined, which should be highly considered in MeVO stroke management.https://svn.bmj.com/content/early/2022/08/31/svn-2022-001561.full |
| spellingShingle | Ning Ma Dapeng Mo Feng Gao Zhongrong Miao Xiaochuan Huo Anxin Wang Raynald Baixue Jia Gaoting Ma Xu Tong Dapeng Sun Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry Stroke and Vascular Neurology |
| title | Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry |
| title_full | Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry |
| title_fullStr | Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry |
| title_full_unstemmed | Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry |
| title_short | Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion: data from ANGEL-ACT registry |
| title_sort | endovascular treatment for acute ischaemic stroke due to medium vessel occlusion data from angel act registry |
| url | https://svn.bmj.com/content/early/2022/08/31/svn-2022-001561.full |
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