Effect of endovascular reperfusion in relation to site of arterial occlusion

Neurology
Robin LemmensDEFUSE 2 IMS III STAR and SWIFT trialists

Abstract

To assess whether the association between reperfusion and improved clinical outcomes after stroke differs depending on the site of the arterial occlusive lesion (AOL). We pooled data from Solitaire With the Intention for Thrombectomy (SWIFT), Solitaire FR Thrombectomy for Acute Revascularisation (STAR), Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution Study 2 (DEFUSE 2), and Interventional Management of Stroke Trial (IMS III) to compare the strength of the associations between reperfusion and clinical outcomes in patients with internal carotid artery (ICA), proximal middle cerebral artery (MCA) (M1), and distal MCA (M2/3/4) occlusions. Among 710 included patients, the site of the AOL was the ICA in 161, the proximal MCA in 389, and the distal MCA in 160 patients (M2 = 131, M3 = 23, and M4 = 6). Reperfusion was associated with an increase in the rate of good functional outcome (modified Rankin Scale [mRS] score 0-2) in patients with ICA (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.7-7.2) and proximal MCA occlusions (OR 6.2, 95% CI 3.8-10.2), but not in patients with distal MCA occlusions (OR 1.4, 95% CI 0.8-2.6). Among patients with M2 occlusions, a subset of the distal MCA cohort, reperfusio...Continue Reading

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Citations

Feb 17, 2017·Cerebrovascular Diseases·Verena van GinnekenJochen B Fiebach
Jul 15, 2017·Journal of Neurointerventional Surgery·Hisham SalahuddinMouhammad Jumaa
Jun 20, 2018·Stroke; a Journal of Cerebral Circulation·Wolfgang G KunzMayank Goyal
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Oct 20, 2018·Neuroradiology·Hyon-Jo KwonHyeon-Song Koh
Nov 10, 2017·Interventional Neurology·Hisham SalahuddinMouhammad A Jumaa
Nov 10, 2017·Interventional Neurology·Niko SillanpääHarri Rusanen
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Jan 27, 2021·Stroke; a Journal of Cerebral Circulation·Tomas DobrockyMirjam R Heldner
Apr 18, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Seung Hwan KimSung-Chul Jin

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