Functional Outcome Following Stroke Thrombectomy in Clinical Practice

Area of Science:

• Neurology
• Interventional Cardiology
• Public Health

Background:

• Endovascular treatment (EVT) is effective for large vessel occlusion (LVO) ischemic stroke.
• Real-world data on EVT outcomes are crucial for understanding its countrywide effectiveness.

Purpose of the Study:

• To estimate real-world reperfusion rates and functional outcomes of EVT for LVO ischemic stroke on a national scale.
• To identify predictors of good functional outcomes after EVT.

Main Methods:

• Prospective registry of 2,794 patients with LVO ischemic stroke across 25 German sites (June 2015-April 2018).
• Primary outcome: modified Rankin Scale (mRS) score at 3 months. Secondary analysis: predictors of good outcome (mRS 0-2).
• Logistic regression used for adjusted analyses of predictors.

Main Results:

• Successful reperfusion achieved in 83% of patients.
• 37% of patients achieved a good outcome (mRS 0-2) at 3 months, with 29% mortality.
• Predictors of good outcome included younger age, no interhospital transfer, lower stroke severity, smaller infarct size, alteplase use, and reperfusion success.

Conclusions:

• Endovascular treatment can achieve high rates of favorable outcomes for ischemic stroke on a countrywide scale.
• Routine clinical practice may show higher mortality rates compared to large randomized trials.
• No significant difference in outcomes was observed between anterior and posterior circulation occlusions.