Outcome Evaluation of Acute Ischemic Stroke Patients Treated with Endovascular Thrombectomy: a Single-Institution Experience in the Era of Randomized Controlled Trials.

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Outcome Evaluation of Acute Ischemic Stroke Patients Treated with Endovascular Thrombectomy: a Single-Institution Experience in the Era of Randomized Controlled Trials.

World Neurosurg. 2016 Dec 22;:

Authors: Sarzetto F, Gupta S, Alotaibi NM, Howard P, da Costa L, Heyn C, Maralani PJ, Guha D, Swartz R, Boyle K, Yang VX

Abstract
BACKGROUND: Endovascular thrombectomy is an effective procedure to treat selected ischemic strokes as shown in recent randomized controlled trials (RCTs). However, the generalizability of these trial data to real-world setting is unknown. The aim of this study was to examine our single center experience with endovascular thrombectomy for acute ischemic strokes and perform a comparative outcome analysis to the most recent RCTs.
METHODS: We performed a 5-year retrospective analysis, from April 2011 to March 2016, on 66 consecutive patients with acute ischemic stroke who received endovascular thrombectomy at our institution. The Alberta Stroke Program Early CT Score (ASPECTS) and the National Institutes of Health Stroke Scale (NIHSS) were used to assess pre-operative status. Our primary outcomes were the modified Rankin Score (mRS) at 90 days and recanalization grade measured by the 6-point thrombolysis in cerebral infarction (TICI) grading system.
RESULTS: Sixty-six patients received endovascular treatment during the study period. Among the patients examined, 35 (53%) had a favorable outcome (mRS 0-2 at 90 days), 23 (35%) a poor outcome (mRS 3-5) and 8 (12%) died. Successful recanalization (TICI score 3-5) was achieved in 68% of cases. In univariate analysis, patients with good outcome at 90 days had significantly greater ASPECTS, lower NIHSS and greater TICI scores. In a multiple logistic regression model, higher ASPECTS and TICI scores were significantly and independently associated with favourable outcome.
CONCLUSION: Excellent outcomes, as demonstrated by the recent RCTs, can be achieved in clinical practice and reproduced in dedicated tertiary centers.

PMID: 28017746 [PubMed - as supplied by publisher]

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