Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability Article Swipe

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Kanta Tanaka , Hiroshi Yamagami , Muhammad M. Qureshi , Kazutaka Uchida , James E. Siegler , Raul G. Nogueira , Shinichi Yoshimura , Nobuyuki Sakai , Nicolas Martinez‐Majander , Simon Nagel , Jelle Demeestere , Volker Puetz , Diogo C Haussen , Mohamad Abdalkader , Marta Olivé‐Gadea , Mahmoud Mohammaden , João Pedro Marto , Anne Dusart , Simon Winzer , Liisa Tomppo , François Caparros , Hilde Hénon , Flavio Bellante , João Nuno Ramos , Santiago Ortega‐Gutiérrez , Sunil A. Sheth , Stefania Nannoni , Johannes Kaesmacher , Lieselotte Vandewalle , Sergio Salazar‐Marioni , Mudassir Farooqui , Pekka Virtanen , Rita Ventura , Syed Zaidi , Alicia C. Castonguay , Ajit S Puri , Behzad Farzin , Hesham Masoud , Piers Klein , Jessica Jesser , Manuel Requena , Tomas Dobrocky , Daniel Kaiser , Erno Peltola , Davide Strambo , Markus Möhlenbruch , Eugene Lin , Peter A. Ringleb , Osama O. Zaidat , Charlotte Cordonnier , Daniel Roy , Robin Lemmens , Marc Ribó , Daniel Strbian , Urs Fischer , Patrik Michel , Jean Saint Raymond , Thanh N. Nguyen ·

YOU? · · 2024 · Open Access · · DOI: https://doi.org/10.5853/jos.2023.04259

Background and Purpose We compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability.Methods In this prespecified analysis of the multinational CT for Late Endovascular Reperfusion study (66 participating sites, 10 countries between 2014 and 2022), we analyzed data from patients with acute ischemic stroke with a pre-stroke modified Rankin Scale (mRS) score of 0–4 and LVO who underwent EVT 6–24 hours from the time last seen well. The primary outcome was the composite of functional independence (FI; mRS score 0–2) or return to the pre-stroke mRS score (return of Rankin, RoR) at 90 days. Outcomes were compared between patients with pre-stroke disability (pre-stroke mRS score 2–4) and those without (mRS score 0–1).Results A total of 2,231 patients (median age, 72 years; median National Institutes of Health Stroke Scale score, 16) were included in the present analysis. Of these, 564 (25%) had pre-stroke disability. The primary outcome (FI or RoR) was observed in 30.7% of patients with pre-stroke disability (FI, 16.5%; RoR, 30.7%) compared to 44.1% of patients without (FI, 44.1%; RoR, 13.0%) (P<0.001). In multivariable logistic regression analysis with inverse probability of treatment weighting, pre-stroke disability was not associated with significantly lower odds of achieving FI or RoR (adjusted odds ratio 0.73, 95% confidence interval 0.43–1.25). Symptomatic intracranial hemorrhage occurred in 6.3% of both groups (P=0.995).Conclusion A considerable proportion of patients with late-presenting LVO and pre-stroke disability regained pre-stroke mRS scores after EVT. EVT may be appropriate for patients with pre-stroke disability presenting in the extended time window.

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Mechanical Engineering

Engineering

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Medicine Modified Rankin Scale Stroke (engine) Odds ratio Confidence interval Logistic regression Internal medicine Occlusion Surgery Ischemic stroke Ischemia Mechanical engineering Engineering

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Type: article
Language: en
Landing Page: https://doi.org/10.5853/jos.2023.04259
PDF: https://www.j-stroke.org/upload/pdf/jos-2023-04259.pdf
OA Status: diamond
Cited By: 6
References: 43
Related Works: 10
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DOI: https://doi.org/10.5853/jos.2023.04259

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Title: Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability

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Language: en

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Publication year: 2024

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Publication date: 2024-05-31

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Authors: Kanta Tanaka, Hiroshi Yamagami, Muhammad M. Qureshi, Kazutaka Uchida, James E. Siegler, Raul G. Nogueira, Shinichi Yoshimura, Nobuyuki Sakai, Nicolas Martinez‐Majander, Simon Nagel, Jelle Demeestere, Volker Puetz, Diogo C Haussen, Mohamad Abdalkader, Marta Olivé‐Gadea, Mahmoud Mohammaden, João Pedro Marto, Anne Dusart, Simon Winzer, Liisa Tomppo, François Caparros, Hilde Hénon, Flavio Bellante, João Nuno Ramos, Santiago Ortega‐Gutiérrez, Sunil A. Sheth, Stefania Nannoni, Johannes Kaesmacher, Lieselotte Vandewalle, Sergio Salazar‐Marioni, Mudassir Farooqui, Pekka Virtanen, Rita Ventura, Syed Zaidi, Alicia C. Castonguay, Ajit S Puri, Behzad Farzin, Hesham Masoud, Piers Klein, Jessica Jesser, Manuel Requena, Tomas Dobrocky, Daniel Kaiser, Erno Peltola, Davide Strambo, Markus Möhlenbruch, Eugene Lin, Peter A. Ringleb, Osama O. Zaidat, Charlotte Cordonnier, Daniel Roy, Robin Lemmens, Marc Ribó, Daniel Strbian, Urs Fischer, Patrik Michel, Jean Saint Raymond, Thanh N. Nguyen

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Landing page: https://doi.org/10.5853/jos.2023.04259

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Concepts: Medicine, Modified Rankin Scale, Stroke (engine), Odds ratio, Confidence interval, Logistic regression, Internal medicine, Occlusion, Surgery, Ischemic stroke, Ischemia, Mechanical engineering, Engineering

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Cited by: 6

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Citations by year (recent): 2025: 5, 2024: 1

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abstract_inverted_index.(25%)	155
abstract_inverted_index.(EVT)	10
abstract_inverted_index.(LVO)	21
abstract_inverted_index.(mRS)	66
abstract_inverted_index.0.73,	217
abstract_inverted_index.0–4	69
abstract_inverted_index.2,231	131
abstract_inverted_index.30.7%	168
abstract_inverted_index.44.1%	180
abstract_inverted_index.Scale	65, 143
abstract_inverted_index.acute	57
abstract_inverted_index.after	247
abstract_inverted_index.days.	109
abstract_inverted_index.hours	76
abstract_inverted_index.lower	207
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abstract_inverted_index.study	41
abstract_inverted_index.those	123
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abstract_inverted_index.0–2)	95
abstract_inverted_index.13.0%)	187
abstract_inverted_index.16.5%;	175
abstract_inverted_index.2022),	50
abstract_inverted_index.2–4)	121
abstract_inverted_index.30.7%)	177
abstract_inverted_index.44.1%;	185
abstract_inverted_index.6–24	75
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abstract_inverted_index.Stroke	142
abstract_inverted_index.groups	230
abstract_inverted_index.median	137
abstract_inverted_index.return	97
abstract_inverted_index.score,	144
abstract_inverted_index.scores	246
abstract_inverted_index.sites,	44
abstract_inverted_index.stroke	59
abstract_inverted_index.these,	153
abstract_inverted_index.window	15
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abstract_inverted_index.(return	103
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abstract_inverted_index.present	150
abstract_inverted_index.primary	84, 160
abstract_inverted_index.therapy	9
abstract_inverted_index.window.	263
abstract_inverted_index.without	26, 124, 183
abstract_inverted_index.National	138
abstract_inverted_index.Outcomes	110
abstract_inverted_index.analysis	32, 193
abstract_inverted_index.analyzed	52
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abstract_inverted_index.interval	220
abstract_inverted_index.ischemic	58
abstract_inverted_index.logistic	191
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abstract_inverted_index.outcomes	6
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abstract_inverted_index.(adjusted	214
abstract_inverted_index.achieving	210
abstract_inverted_index.analysis.	151
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abstract_inverted_index.countries	46
abstract_inverted_index.occlusion	20
abstract_inverted_index.treatment	198
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abstract_inverted_index.regression	192
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abstract_inverted_index.Symptomatic	222
abstract_inverted_index.appropriate	252
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abstract_inverted_index.large-vessel	19
abstract_inverted_index.prespecified	31
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abstract_inverted_index.0.43–1.25).	221
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abstract_inverted_index.late-presenting	238
abstract_inverted_index.disability.Methods	28
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institutions_distinct_count	58
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