Discrepancy between post-treatment infarct volume and 90-day outcome in the ESCAPE randomized controlled trial.

International Journal of Stroke : Official Journal of the International Stroke Society
Aravind GaneshMayank Goyal

Abstract

Some patients with ischemic stroke have poor outcomes despite small infarcts after endovascular thrombectomy, while others with large infarcts sometimes fare better. We explored factors associated with such discrepancies between post-treatment infarct volume (PIV) and functional outcome. We identified patients with small PIV (volume ≤ 25th percentile) and large PIV (volume ≥ 75th percentile) on 24-48-h CT/MRI in the ESCAPE randomized-controlled trial. Demographics, comorbidities, baseline, and 24-48-h stroke severity (NIHSS), stroke location, treatment type, post-stroke complications, and other outcome scales like Barthel Index, and EQ-5D were compared between "discrepant cases" - those with 90-day modified Rankin Scale(mRS) ≤ 2 despite large PIV or mRS ≥ 3 despite small PIV - and "non-discrepant cases". Multi-variable logistic regression was used to identify pre-treatment and post-treatment factors associated with small-PIV/mRS ≥ 3 and large-PIV/mRS ≤ 2. Sensitivity analyses used different definitions of small/large PIV and good/poor outcome. Among 315 patients, median PIV was 21 mL; 27/79 (34.2%) patients with PIV ≤ 7 mL (25th percentile) had mRS ≥ 3; 12/80 (15.0%) with PIV ≥ 72 mL (75th percentile) had mRS ≤ 2. Discrepant ca...Continue Reading

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Citations

Nov 27, 2020·Journal of Neurointerventional Surgery·Bijoy K MenonUNKNOWN ESCAPE-NA1 investigators
Feb 5, 2021·Stroke; a Journal of Cerebral Circulation·Amy Y X Yu, Michael D Hill
Oct 10, 2020·AJNR. American Journal of Neuroradiology·M GoyalUNKNOWN AHA/ASA Stroke Council Science Subcommittees: Emergency Neurovascular Care (ENCC), the Cardiovascular and Stroke Nursing Cou
Mar 27, 2021·Stroke; a Journal of Cerebral Circulation·Mayank GoyalAravind Ganesh
Mar 31, 2021·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Petra CimflovaWu Qiu
Jun 26, 2021·AJNR. American Journal of Neuroradiology·J M OspelUNKNOWN ESCAPE-NA1 investigators

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Software Mentioned

ASPECTS
VISTA
ESCAPE
REVASCAT

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