Abstract T MP4: The Rapidity of Recanalization is an Independent Factor to Achieve Good Clinical Outcome After Intraarterial Thrombectomy
Background: The present study evaluated whether the time interval from symptom onset to recanalization (onset-to-recanalization time) was independently related with the clinical outcomes after intraarterial thrombectomy (IAT) in acute ischemic stroke patients.
Methods: We analyzed clinical and radiological data of 140 consecutive patients who underwent IAT for terminal internal carotid and/or middle cerebral artery occlusions. The patients were classified into 4 groups by the onset-to-recanalization time; <4.5, 4.5-6, >6 hours, and no recanalization (NR). Subsequent changes of the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were compared between the four time interval groups. The independent relationship of the onset-to-recanalization time with the clinical outcomes was analyzed with other clinical and radiological parameters simultaneously checked before and after IAT using multivariate analyses.
Results: Successful recanalization after IAT was performed in 47 (34%) <4.5hours, 39 (28%) 4.5-6 hours, 31 (22%) patients >6 hours groups, no recanalization in 23 patients (16%). Even though initial NIHSS score was not different between the four groups (<4.5 hrs, 12.2±4.0; 4.5-6hrs, 12.2±4.2; >6hrs, 12.1±3.3; NR, 12.8±3.3, p>0.05), two first groups who recanalized within 6 hour showed more significant reductions of NIHSS at discharge (<4.5 hrs, 5.4±5.8; 4.5-6hrs, 6.5±6.7; >6hrs, 9.6±6.0; NR, 12.7±4.0, p<0.001). The first two groups showed more favorable outcome (mRS 0-2) at discharge (<4.5hrs, 51%; 4.5-6hrs, 51%; >6hrs, 13%; NR, 0, p<0.001) and 3 months later (<4.5hrs, 62%; 4.5-6hrs, 63%; >6hrs, 23%; NR, 0, p<0.001) rather than other 2 groups. On the multiple regression analysis, recanalization within 6 hours was an independent parameter related with the favorable outcome at 3 months after IAT (OR 15.5, 95% CI 2.0-119.8, p=0.009) along with less extensive lesions on initial brain image (OR 13.2, 95% CI 1.7-103.3, p=0.014) and high recanalization grade (OR 13.0, 95% CI 1.5-115.6, p=0.022).
Conclusions: The present study showed that the successful recanalization within 6 hours might be an independent clinical parameter to achieve favorable outcome after IAT for ischemic stroke patients.
Author Disclosures: H. Jeong: None. H. Song: None. H. Kwon: None. H. Koh: None. J. Kim: None.
- © 2014 by American Heart Association, Inc.