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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.7K

Treatment of patients with mild acute ischemic stroke and associated large vessel occlusion

Russell Cerejo1, Esteban Cheng-Ching2, Ferdinand Hui1

  • 1Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, S80, Cleveland, OH 44195, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|April 7, 2016
PubMed

Insights

Patients with mild stroke symptoms and large vessel occlusion (LVO) may face poor outcomes. Early acute stroke treatment (AST) significantly improves outcomes compared to conservative management, even in mild cases.

Area of Science:

  • Neurology
  • Stroke Medicine
  • Vascular Neurology

Background:

  • Mild acute ischemic stroke (mAIS) patients often have unfavorable outcomes, especially with large vessel occlusion (LVO).
  • Current acute stroke treatment (AST) guidelines frequently exclude mAIS patients, potentially leading to suboptimal care.

Purpose of the Study:

  • To evaluate the outcomes of mAIS patients with LVO who received AST versus those who did not.
  • To determine if early intervention in mAIS with LVO improves functional outcomes.

Main Methods:

  • Retrospective review of acute ischemic stroke patients (2010-2014) with initial NIHSS ≤7 due to LVO within 6 hours of onset.
  • Analysis of demographics, treatments received (IV tPA, IA therapy), and 30-day functional outcomes (mRS ≤2).

Main Results:

  • 62 patients met inclusion criteria; 74.1% had anterior circulation LVO.
  • 71.8% received AST, showing 4.5 times higher odds of favorable 30-day outcomes (78.3% vs. 53.8%).
  • No symptomatic intracranial hemorrhage occurred in treated patients.

Conclusions:

  • A significant number of untreated mAIS patients with LVO experience poor outcomes.
  • Early AST in mAIS patients with LVO is associated with better functional recovery.
  • Prompt LVO detection in mild stroke symptoms should trigger rapid treatment considerations.

Keywords:
Acute stroke therapyLarge vessel occlusionMild ischemic stroke

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