01 December 2022>: Clinical Research
Clinical Outcomes of Extracranial Carotid Artery-Related Stroke Eligible for Mechanical Reperfusion on Top of Per-Guidelines Thrombolytic Therapy: Analysis from a 6-Month Consecutive Patient Sample in 2 Centers
Karolina Dzierwa 12ABDEF* , Magdalena Knapik 234ABDEF , Łukasz Tekieli 235ABDEF , Adam Mazurek 23ABDEF , Małgorzata Urbańczyk-Zawadzka 26BCD , Artur Klecha 7ABD , Tomasz Kowalczyk 7ABD , Teresa Koźmik 7ABD , Łukasz Wiewiórka 2567ABD , Paweł Banyś 6BCD , Ewa Węglarz 25BC , Justyna Stefaniak 8CD , Rafał T. Nizankowski 9ADF , Iris Q. Grunwald 1011ADEF , Piotr Musiałek 23ABCDEF*DOI: 10.12659/MSM.938549
Med Sci Monit 2022; 28:e938549
Table 1 Characteristics of study patients and lesions.
Total | EMR-treated | EMR-untreated | p | |
---|---|---|---|---|
No. of patients | 30 | 12 | 18 | |
Age (median, Q1–Q3) | 68.5 (60.2–75.5) | 70.5 (62.5–79) | 68.5 (59.2–73.5) | 0.39 |
Concomitant AF, N, % | 3 (10%) | 2 (16.7%) | 1 (5.6%) | 0.54 |
Diabetes, n, % | 9 (30%) | 4 (33.3%) | 5 (27.8%) | 1.0 |
CAD, n, % | 12 (40.0%) | 5 (41.7%) | 7 (38.9%) | 1.0 |
Sex, man, n, % | 25 (83.3%) | 10 (83.3%) | 15 (83.3%) | 1.0 |
Symptom onset to first presentation time, hours (median, Q1–Q3) | 4 (2–5) | 4 (3–6.5) | 3.25 (2–5) | 0.37 |
Qualifying NIHSS, (median, Q1–Q3) | 17 (12–18) | 14 (12–17) | 16 (12–19) | 0.58 |
Pre-onset mRS 0, n, % | 25 (83.3%) | 9 (75%) | 16 (88.9%) | 0.36 |
ASPECTS 9 or 10, n, % | 28 (93.3%) | 12 (100%) | 16 (88.9%) | 0.50 |
Pt on OMT, n, % | 13 (43.3%) | 5 (41.6%) | 8 (44.4%) | 1.0 |
Extracranial ICA severe stenosis/near-occlusion, n, % | 15 (50.0%) | 8 (66.7%) | 7 (38.9%) | 0.26 |
Extracranial ICA acute occlusion, n, % | 15 (50.0%) | 4 (33.3%) | 11 (61.1%) | 0.26 |
Tandem lesion, n, % | 8 (26.7%) | 1 (8.3%) | 7 (38.9%) | 0.099 |
Thrombolysis given, n, % | 10 (33.3%) | 2 (16.7%) | 8 (44.4%) | 0.23 |
Stroke mechanism | ||||
H | 14 (46.7%) | 8 (66.7%) | 6 (33.3%) | 0.13 |
E | 4 (13.3%) | 1 (8.3%) | 3 (16.7%) | 0.63 |
H+E, n, % | 12 (40.0%) | 3 (25%) | 9 (50.0%) | 0.71 |
Affected side left, n, % | 16 (53.3%) | 4 (33.3%) | 12 (66.7%) | 0.13 |
Presentation to intervention time, min (median, Q1–Q3) | NA | 105 (57.5–172.5) | NA | NA |
Proximal protection, n, % | NA | 11 (91.7%) | NA | NA |
Thrombectomy performed, n, % | NA | 3 (25%) | NA | NA |
Micronet-covered stent, n, % | NA | 12 (100%) | NA | NA |
Puncture to recanalization time, min (median, Q1–Q3) | NA | 64.5 (47.7–83.7) | NA | NA |
Recanalization outcome | ||||
mTICI 2b/c | NA | 2 (16.7%) | NA | NA |
mTICI 3 | NA | 10 (83.3%) | NA | NA |
90-day mRS (0–2) | 11 (36.7%) | 11 (91.7%) | 0 (0.0%) | |
90-day mRS (3–5) | 17 (56.7%) | 1 (8.3%) | 16 (88.9%) | |
90-day mRS (6) | 2 (6.7%) | 0 (0.0%) | 2 (11.1%) | 0.51 |
Data are provided (median, Q1–Q3, or n, proportion) for clinical and lesion/stroke characteristics for entire study cohort (Total) and for the 2 groups (EMR-treated and EMR-untreated) AF – atrial fibrillation; ASPECTS – Alberta Stroke Program Early Computed Tomography Score; CAD – coronary artery disease; E – embolic; EMR – Emergency Mechanical Reperfusion; H – hemorrhagic; ICA – Internal Carotid Artery; NIHSS – National Institutes of Health Stroke Scale; mRS – modified Rankin Score; OMT – Optimal Medical Therapy; mTICI – modified Thrombolysis in Cerebral Infarction scale. |