Outcomes of a Contemporary Cohort of 536 Consecutive Patients With Acute Ischemic Stroke Treated With Endovascular Therapy
Authors: Abilleira Sònia , Cardona Pere , Ribó Marc , Millán Mònica , Obach Víctor , Roquer Jaume , Cánovas David , Martí-Fàbregas Joan , Rubio Francisco , Álvarez-Sabín José , Dávalos Antoni , Chamorro Ángel , de Miquel Maria Angeles , Tomasello Alejandro , Castaño Carlos , Macho Juan M. , Ribera Aida , Gallofré Miquel , Sanahuja Jordi , Purroy Francisco , Serena Joaquín , Castellanos Mar , Silva Yolanda , van Eendenburg Cecile , Pellisé Anna , Ustrell Xavier , Marés Rafael , Baiges Juanjo , Garcés Moisés , Saura Júlia , Soler Insa Josep Maria , Aragonés Josep Maria , Otermín Pilar , Cocho Dolores , Palomeras Ernest , Pérez de la Ossa Natalia , Gomis Meritxell , López-Cancio Elena , Dorado Laura , Aleu Aitzíber , García-Bermejo Pablo , Rubiera Marta , Santamarina Esteban , Pagola Jorge , Molina Carlos , Coscojuela Pilar , Quesada Helena , Cano Lluis , Aja Lucia , Mora Paloma , Cervera Álvaro , Amaro Sergio , Urra Xabier , Blasco-Andaluz Jordi , San Roman Luis , Delgado-Mederos Raquel , Dinia Lavinia , Carrera-Giraldo David , Rodríguez-Campello Ana , Ois Ángel , Cuadrado-Godia Elisa , Vivas Elio , del Carmen Garcia Maria , Estela Jordi , Perendreu Joan , Krupinski Jerzy , Huertas-Folch Sonia , Nicolás-Herrerias M. Carme , Gómez-Choco Manuel , García Sonia , Martínez Raul 
Published: March 2014

Background and Purpose—

We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome.

Methods—

We used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusion therapies for consecutive patients with acute ischemic stroke since 2011. We described outcomes overall and by subgroups (age ≤ or >80 years; onset-to-groin puncture ≤ or >6 hours; anterior or posterior strokes; previous IV recombinant tissue-type plasminogen activator or isolated endovascular treatment/therapy; revascularization or no revascularization), and determined independent predictors of good outcome (modified Rankin Scale score ≤2) and mortality at 3 months by multivariate modeling.

Results—

We analyzed 536 patients, of whom 285 received previous IV recombinant tissue-type plasminogen activator. Overall, revascularization (modified Thrombolysis In Cerebral Infarction scores, 2b and 3) occurred in 73.9%, 5.6% developed symptomatic intracerebral hemorrhages, 43.3% achieved good functional outcome, and 22.2% were dead at 90 days. Adjusted comparisons by subgroups systematically favored revascularization (lower proportion of symptomatic intracerebral hemorrhages and death rates and higher proportion of good outcome). Multivariate analyses confirmed the independent protective effect of revascularization. Additionally, age >80 years, stroke severity, hypertension (deleterious), atrial fibrillation, and onset-to-groin puncture ≤6 hours (protective) also predicted good outcome, whereas lack of previous disability and anterior circulation strokes (protective) as well as and hypertension (deleterious) independently predicted mortality.

Conclusions—

This study reinforces the role of revascularization and time to treatment to achieve enhanced functional outcomes and identifies other clinical features that independently predict good/fatal outcome after endovascular treatment/therapy.