RT info:eu-repo/semantics/article
T1 Delayed Neurological Improvement After Full Endovascular Reperfusion in Acute Anterior Circulation Ischemic Stroke
A1 Talavera, Blanca
A1 Gómez Vicente, Beatriz
A1 Martínez Galdámez, Mario
A1 López Cancio, Elena
A1 García Cabo, Carmen
A1 Castellanos, Mar
A1 Roel, Alexia
A1 Tejada Meza, Herbert
A1 Marta Moreno, Javier
A1 Pérez Lázaro, Cristina
A1 Navarro Pérez, María Pilar
A1 Bravo Anguiano, Yolanda
A1 Bártulos Iglesias, Mónica
A1 Tejada García, Javier
A1 Rodrigo Stevens, Gabriela
A1 Martínez Zabaleta, Maite
A1 Riva, Patricia de la
A1 Timiraos Fernández, Juan José
A1 Mar Freijo, María del
A1 Luna, Alain
A1 García Sánchez, Juan Manuel
A1 Gil Alzueta, María del Carmen
A1 Palacio Portilla, Enrique Jesús
A1 Jiménez López, Yésica
A1 López Mesonero, Luis
A1 Redondo Robles, Laura
A1 Mayo Iscar, Agustín
A1 Arenillas Lara, Juan Francisco
K1 brain; ischemic stroke; outcome; reperfusion; thrombectomy.
AB Background and purpose: We aimed to determine the prevalence and predictors of delayed neurological improvement (DNI) after complete endovascular reperfusion in anterior circulation acute ischemic stroke (AIS).Methods: Retrospective analysis of an online multicenter prospective reperfusion registry of patients with consecutive anterior circulation AIS treated with endovascular thrombectomy (EVT) from January 2018 to June 2019 in tertiary stroke centers of the NORDICTUS (NORD-Spain Network for Research and Innovation in ICTUS) network. We included patients with AIS with a proximal occlusion in whom a modified Thrombolysis in Cerebral Infarction 3 reperfusion pattern was obtained. DNI was defined if, despite absence of early neurological improvement during the first 24 hours, patients achieved functional independence on day 90. Clinical and radiological variables obtained before EVT were analyzed as potential predictors of DNI.Results: Of 1565 patients with consecutive AIS treated with EVT, 1381 had proximal anterior circulation occlusions, 803 (58%) of whom achieved a modified Thrombolysis in Cerebral Infarction 3. Of these, 628 patients fulfilled all selection criteria and were included in the study. Mean age was 73.8 years, 323 (51.4%) were female, and median baseline National Institutes of Health Stroke Scale was 16. Absence of early neurological improvement was observed in 142 (22.6%) patients; 32 of these (22.5%) achieved good long-term outcome and constitute the DNI group. Predictors of DNI in multivariable-adjusted logistic regression were male sex (odds ratio, 6.4 [95% CI, 2.1–22.3] P=0.002), lower pre-EVT National Institutes of Health Stroke Scale score (odds ratio, 1.4 [95% CI, 1.2–1.5], P<0.001), and intravenous thrombolysis (odds ratio, 9.1 [95% CI, 2.7–30.90], P<0.001).Conclusions: One-quarter of patients with anterior circulation AIS who do not clinically improve within the first 24 hours after complete cerebral endovascular recanalization will achieve long-term functional independence, regardless of the poor early clinical course. Male sex, lower initial clinical severity, and use of intravenous thrombolysis before EVT predicted this clinical pattern.
PB Lippincott Williams & Wilkins
SN 0039-2499
YR 2021
FD 2021
LK https://uvadoc.uva.es/handle/10324/74067
UL https://uvadoc.uva.es/handle/10324/74067
LA spa
NO Stroke. 2021 Jul;52(7):2210-2217.
NO Producción Científica
DS UVaDOC
RD 31-ene-2025