Futile reperfusion and predicted therapeutic benefits after successful endovascular treatment according to initial stroke severity
- Authors
- Lee, Sang-Hwa; Kim, Beom Joon; Han, Moon-Ku; Park, Tai Hwan; Lee, Kyung Bok; Lee, Byung-Chul; Yu, Kyung-Ho; Oh, Mi Sun; Cha, Jae Kwan; Kim, Dae-Hyun; Nah, Hyun-Wook; Lee, Jun; Lee, Soo Joo; Kim, Jae Guk; Park, Jong-Moo; Kang, Kyusik; Cho, Yong-Jin; Hong, Keun-Sik; Park, Hong-Kyun; Choi, Jay Chol; Kim, Joon-Tae; Choi, Kangho; Kim, Dong-Eog; Ryu, Wi-Sun; Kim, Wook-Joo; Shin, Dong-Ick; Yeo, Minju; Sohn, Sung-Il; Hong, Jeong-Ho; Lee, Juneyoung; Lee, Ji Sung; Khatri, Pooja; Bae, Hee-Joon
- Issue Date
- 15-1월-2019
- Publisher
- BMC
- Keywords
- Futile reperfusion; Endovascular treatment; Stroke severity; Therapeutic benefit
- Citation
- BMC NEUROLOGY, v.19
- Indexed
- SCIE
SCOPUS
- Journal Title
- BMC NEUROLOGY
- Volume
- 19
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/68286
- DOI
- 10.1186/s12883-019-1237-2
- ISSN
- 1471-2377
- Abstract
- BackgroundFutile reperfusion (poor functional status despite successful reperfusion) was observed in up to 67% of patients enrolled in recent endovascular treatment (EVT) clinical trials. We investigated the impact of baseline stroke severity on both futile reperfusion and therapeutic benefit of successful EVT.MethodsUsing a prospective multicenter stroke registry, we identified consecutive ischemic stroke patients with anterior circulation large artery occlusion, who were reperfused successfully by EVT (Thrombolysis in Cerebral Infarction grade 2b-3). The rate of futile reperfusion was assessed across the initial National Institutes of Health Stroke Scale (NIHSS) scores. The frequency of poor outcomes (modified Rankin scale [mRS] 3-6) according to NIHSS scores was compared between patients revascularized successfully by EVT and those who did not receive EVT, after standardizing for age.ResultsAmong 21,591 patients with ischemic stroke, 972 (4.5%) received EVT within 12h of onset, including 440 who met study eligibility criteria. Futile reperfusion was observed in 226 of the 440 study-eligible patients (51.4%) and was associated with stroke severity: 20.9% in NIHSS scores 5, 34.6% in 6-10, 58.9% in 11-20, and 63.8% in >20 (p<0.001). Nonetheless, the therapeutic benefit of EVT also increased with increasing stroke severity (p for interaction <0.001): 0.1% in NIHSS 5, 18.6% in 6-10, 28.7% in 11-20, and 34.3% in >20.ConclusionsEVT is more beneficial with increasing stroke severity, although futile reperfusion also increases with higher stroke severity.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.