The prognostic value of extracranial vascular characteristics on procedural duration and revascularization success in endovascularly treated acute ischemic stroke patients.
Endovascular treatment
Stroke
aortic arch
carotid arteries
tortuosity
Journal
European stroke journal
ISSN: 2396-9881
Titre abrégé: Eur Stroke J
Pays: England
ID NLM: 101688446
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
21
09
2021
accepted:
01
12
2021
entrez:
18
3
2022
pubmed:
19
3
2022
medline:
19
3
2022
Statut:
ppublish
Résumé
Vascular anatomy might affect endovascular treatment success in acute ischemic stroke patients with large vessel occlusion. We investigated the prognostic value of extracranial vascular characteristics on procedural time and revascularization success in patients with large vessel occlusion in the anterior cerebral circulation. We included 828 patients endovascularly treated within 6.5 hours of symptom onset from the Dutch MR CLEAN-Registry. We evaluated aortic arch configuration, stenosis and tortuosity of supra-aortic arteries, and internal carotid arteries (ICAs) on pre-intervention CTA. We constructed logistic prediction models for outcome variables procedural duration (≥60 minutes) and non-successful revascularization (extended thrombolysis in cerebral infarction (eTICI) of 0-2A) using baseline characteristics and assessed the effect of extracranial vascular characteristics on model performance. Cervical ICA tortuosity and stenosis ≥99% improved prediction of long procedural duration compared with baseline characteristics from area under the curve of 0.61 (95% CI: 0.57-0.65) to 0.66 (95% CI: 0.62-0.70) ( Extracranial vascular characteristics have additional prognostic value for procedural duration, but not for revascularization success, compared with baseline characteristics. Performance of both prediction models is limited in patients treated for large vessel occlusion.
Identifiants
pubmed: 35300259
doi: 10.1177/23969873211067662
pii: 10.1177_23969873211067662
pmc: PMC8921792
doi:
Types de publication
Journal Article
Langues
eng
Pagination
48-56Informations de copyright
© European Stroke Organisation 2022.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AL received grants from: Cerenovus, Penumbra, Stryker, Medtronic, Dutch Heart Foundation, The Netherlands Organisation for Health Research and Development, Health Holland Top Sector Life Sciences & Health and from Dutch Brain Foundation. CBLMM received grants during the conduct of the study (paid to institution) from TWIN Foundation and outside of the submitted work (paid to institution) from CVON/Dutch Heart Foundation, European Commission, Dutch Health Evaluation Program and from Stryker; and is shareholder of Nico.Lab. HAM is co-founder and shareholder of Nico.Lab. GH, MPMES, TD, NDK, JJG, WJS, GJLN, LSFY, FJAM, MJHW and MAAW declared no conflict interest.
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