Abstract P543: Duration of Ischemia is Associated With Outcome After Endovascular Reperfusion Independent of Infarct Size
| العنوان: | Abstract P543: Duration of Ischemia is Associated With Outcome After Endovascular Reperfusion Independent of Infarct Size |
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| المؤلفون: | Arnd Doerfler, Sunil A Sheth, Johanna T Fifi, Albert J Yoo, Keith Woodward, Alejandro Tomasello, Ameer E Hassan, Osama O. Zaidat, Ashish Nanda, Benjamin Atchie |
| المصدر: | Stroke. 52 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Advanced and Specialized Nursing, medicine.medical_specialty, business.industry, Ischemia, medicine.disease, Infarct size, Endovascular therapy, Internal medicine, Cardiology, medicine, Functional independence, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Acute ischemic stroke, Stroke, Large vessel occlusion |
| الوصف: | Introduction: Despite advanced imaging and rapid recanalization, the majority of patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) do not achieve functional independence at 90 days. Here, we explore the hypothesis that prolonged ischemia worsens clinical outcome beyond changes reflected in final infarct size, particularly in elderly patients. Methods: From the prospective, multicenter COMPLETE (Penumbra, Inc) registry, patients were included if they underwent endovascular therapy (EVT) for anterior circulation LVO, achieved TICI 2b/3 reperfusion, and EVT began within 90 minutes of imaging. Final infarct volumes (FIV) were measured on 24-48h post-EVT scans using ASPECTS. Multivariable logistic regression was used to determine the effect of stroke onset to hospital arrival time (OTA) on likelihood of functional independence (mRS 0-2) at 90 days, adjusting for age, NIHSS, occlusion location, pre-morbid mRS and final infarct. The effect of OTA on outcome was evaluated in older vs. younger patients using propensity score matching. Data are presented as median [IQR] or OR [95% CI]. Results: Among 302 patients, median age was 71 [61-79], NIHSS was 15 [10-20], 56% were female, median OTA was 154 [75-320]. Median FIV ASPECTS was 7 [6-8]. In multivariable analysis adjusting for FIV, longer OTA was associated with decreased likelihood of functional independence (OR 0.74 [0.57-0.96]). FIV-independent worsening with prolonged OTA was more pronounced with advanced age (Figure). Using propensity score matching, elderly patients (age > 70) matched by age, NIHSS, occlusion location and FIV were less likely to have functional independence with prolonged OTA (Coef -0.2, p Conclusions: In patients with LVO AIS who achieve successful reperfusion, delays in EVT reduce the likelihood of good clinical outcomes independent of FIV. This effect is more pronounced with advanced age. |
| تدمد: | 1524-4628 0039-2499 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::78c21d67a3e2ce6f59c87fe1c0800081 https://doi.org/10.1161/str.52.suppl_1.p543 |
| رقم الأكسشن: | edsair.doi...........78c21d67a3e2ce6f59c87fe1c0800081 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244628 00392499 |
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