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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Long-term outcome changes after mechanical thrombectomy for anterior circulation acute ischemic stroke
Hannah Fuhrer1, Lisa Forner2, Pascal Pruellage2
1Department of Neurology, University Hospital Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany. hannah.fuhrer@uniklinik-freiburg.de.
Journal of Neurology
|December 14, 2019
Summary
Mechanical thrombectomy (MT) offers good long-term outcomes for acute ischemic stroke patients. While outcomes stabilize by 3 months, successful recanalization is key, and right-sided strokes may predict slower recovery.
Area of Science:
- Neurology
- Interventional Neurology
- Stroke Medicine
Background:
- Mechanical thrombectomy (MT) is established for improving early outcomes in acute ischemic stroke.
- However, limited data exists on factors influencing long-term results after MT.
Purpose of the Study:
- To investigate long-term outcomes following MT for acute ischemic stroke.
- To identify predictors of outcome changes and favorable long-term results.
Main Methods:
- Analysis of a prospective MT registry (2014-2017) including patients with anterior circulation large vessel occlusion.
- Comparison of modified Rankin Scale (mRS) scores at 3 months and 12 months post-treatment.
- Multivariable regression analysis to determine outcome predictors.
Main Results:
- 42.0% of patients achieved a favorable long-term outcome (mRS 0-2).
- No significant overall change in mRS was observed between 3 and 12 months (∆mRS = -0.004).
- Right hemispheric stroke and higher NIHSS at discharge predicted worse long-term outcomes, while successful recanalization predicted favorable outcomes.
Conclusions:
- A substantial proportion of patients experience favorable long-term outcomes after MT.
- Outcomes are generally stable between 3 and 12 months, with rare late mortality.
- Successful recanalization is a strong positive predictor, whereas stroke laterality and initial severity may indicate potential for delayed decline.
