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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Published on: January 18, 2018

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Predictors of a Favorable Outcome after Emergent Carotid Artery Stenting in Acute Anterior Circulation Stroke

Gyeong Il Moon, Byung Hyun Baek, Seul Kee Kim

    Taehan Yongsang Uihakhoe Chi
    |October 14, 2022
    PubMed

    Insights

    Predictors of good outcomes after emergent carotid artery stenting (CAS) for acute stroke were identified. Baseline infarct size, successful reperfusion, and parenchymal hemorrhage significantly influenced patient recovery following CAS.

    Area of Science:

    • Neurology
    • Interventional Cardiology
    • Vascular Surgery

    Background:

    • Acute anterior circulation stroke poses a significant health burden.
    • Emergent carotid artery stenting (CAS) is a critical intervention for selected stroke patients.
    • Identifying predictors of favorable outcomes is crucial for optimizing CAS treatment strategies.

    Purpose of the Study:

    • To identify independent predictors of favorable outcomes in patients undergoing emergent CAS for acute anterior circulation stroke.
    • To analyze factors associated with successful recovery (modified Rankin Scale 0-2 at 90 days).

    Main Methods:

    • A cohort of 93 patients with acute stroke undergoing emergent CAS within 6 hours of symptom onset was studied.
    • Data were compared between patients with and without favorable outcomes.
    • Logistic regression analysis was employed to determine independent predictors of favorable outcomes.

    Main Results:

    • Intracranial tandem occlusion was present in 81.7% of patients.
    • Successful intracranial reperfusion was achieved in 74.2% of patients, with 51.6% experiencing favorable outcomes.
    • Independent predictors of favorable outcomes included a higher diffusion-weighted imaging-Alberta Stroke Program Early CT Score (OR, 1.487), successful reperfusion (OR, 5.199), and absence of parenchymal hemorrhage (OR, 0.042).

    Conclusions:

    • Baseline infarct size, successful reperfusion, and parenchymal hemorrhage are independent predictors of favorable outcomes after emergent CAS.
    • These findings aid in patient selection and risk stratification for emergent CAS in acute stroke.
    Abstract

    Keywords:
    Acute StrokeCarotid Artery StentingPrognosisThrombectomy

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