A retrospective study of clinical outcomes after endovascular treatment in acute ischemic stroke patients with complete anterior circulation infarction (TACI) in the absence of multimodal CT.

A retrospective study of clinical outcomes after endovascular treatment in acute ischemic stroke patients with complete anterior circulation infarction (TACI) in the absence of multimodal CT.

World Neurosurg. 2017 Jun 02;:

Authors: Xu C, Tao A, Wang P, Wang Z, Zhang Y, Tao X, Xin H, Zheng X, Ying J

Abstract
OBJECTIVE: To analyze the positive predictive value of large artery occlusion and clinical prognosis in acute ischemic stroke patients with total anterior circulation infarct (TACI) who underwent endovascular treatment in the absence of multimodal CT angiography (CTA)/ CT perfusion (CTP).
METHODS: The inclusion criteria for the acute ischemic stroke patients to receive endovascular treatment were as the follows: the OCSP classification was TACI, Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≥ 6, National Institutes of Health stroke scale (NIHSS) score ≥8, and within 4.5 hours of stroke onset. The endovascular treatment was performed on patients who met the inclusion criteria. The endovascular treatment included intra-arterial thrombolysis, mechanical treatments, or both. A retrospective analysis was performed on all eligible acute ischemic stroke patients who underwent endovascular treatment from January 1, 2015 to December 31, 2015.
RESULTS: A total of 17 patients met the inclusion criteria and underwent endovascular treatment. The median age was 76 years (range, 59-88 years). 12 patients (70.6%) were diagnosed with atrial fibrillation. 16 patients were diagnosed with large artery occlusion by digital subtraction angiography (DSA), and the positive predictive value was 94.1%. 16 patients (94.1%) had recanalization (TICI Grade 3); 12 patients (70.6%) had modified Rankin Scale (mRS) of 0-2 and 1 patient (5.9%) died at 90 days post-treatment.
CONCLUSIONS: In the absence of multimodal CT, endovascular treatment might be beneficial to patients with TACI acute ischemic stroke within 4.5 hours of stroke onset, who had NIHSS score≥8 and ASPECTS ≥6. These inclusion criteria have a high positive predictive value for anterior circulation large artery occlusion.

PMID: 28583459 [PubMed - as supplied by publisher]

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