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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Long-term mortality after endovascular thrombectomy for stroke
Ulla Junttola1, Sanna Lahtinen2, Juha-Matti Isokangas3
1Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care, Finland; Departments of Neurology, Oulu University Hospital, OYS, P.O.BOX 21, Oulu 90029, Finland.
Summary
Long-term mortality after endovascular thrombectomy (EVT) for acute ischemic stroke is influenced by functional dependence, stroke severity, comorbidity, and medical complications. These factors, not procedural aspects, are key predictors of patient outcomes.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Endovascular thrombectomy (EVT) is the standard treatment for acute ischemic stroke with large vessel occlusion (LVO).
- Clinical outcomes are typically assessed at three months, with limited data on long-term prognosis after EVT.
- Understanding long-term mortality is crucial for comprehensive stroke care.
Purpose of the Study:
- To evaluate the long-term mortality rates in patients following EVT for stroke.
- To identify factors associated with long-term mortality after EVT.
Main Methods:
- Retrospective analysis of 323 patients who underwent EVT for stroke (2015-2019) and survived at least 30 days.
- Follow-up extended to the end of 2020.
- Cox regression analysis was employed to determine mortality predictors.
Main Results:
- 16.4% of 30-day survivors (53 patients) died during the follow-up period.
- Long-term mortality was significantly associated with functional dependence (mRS >2), comorbidity (CCI ≥3), baseline stroke severity (NIHSS >8), and medical complications.
- Procedural variables did not significantly impact mortality.
Conclusions:
- Functional dependence, stroke severity, comorbidity, and in-hospital medical complications are significant predictors of long-term mortality after EVT for stroke.
- These findings highlight the importance of managing patient-specific factors for improved long-term outcomes.
