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01 December 2022: Clinical Research

Clinical Outcomes of Extracranial Carotid Artery-Related Stroke Eligible for Mechanical Reperfusion on Top of Per-Guidelines Thrombolytic Therapy: Analysis from a 6-Month Consecutive Patient Sample in 2 Centers

Karolina Dzierwa 12ABDEF* , Magdalena Knapik 234ABDEF , Łukasz Tekieli 235ABDEF , Adam Mazurek 23ABDEF , Małgorzata Urbańczyk-Zawadzka 26BCD , Artur Klecha 7ABD , Tomasz Kowalczyk 7ABD , Teresa Koźmik 7ABD , Łukasz Wiewiórka 2567ABD , Paweł Banyś 6BCD , Ewa Węglarz 25BC , Justyna Stefaniak 8CD , Rafał T. Nizankowski 9ADF , Iris Q. Grunwald 1011ADEF , Piotr Musiałek 23ABCDEF*

DOI: 10.12659/MSM.938549

Med Sci Monit 2022; 28:e938549

Table 1 Characteristics of study patients and lesions.

TotalEMR-treatedEMR-untreatedp
No. of patients301218
Age (median, Q1–Q3)68.5 (60.2–75.5)70.5 (62.5–79)68.5 (59.2–73.5)0.39
Concomitant AF, N, %3 (10%)2 (16.7%)1 (5.6%)0.54
Diabetes, n, %9 (30%)4 (33.3%)5 (27.8%)1.0
CAD, n, %12 (40.0%)5 (41.7%)7 (38.9%)1.0
Sex, man, n, %25 (83.3%)10 (83.3%)15 (83.3%)1.0
Symptom onset to first presentation time, hours (median, Q1–Q3)4 (2–5)4 (3–6.5)3.25 (2–5)0.37
Qualifying NIHSS, (median, Q1–Q3)17 (12–18)14 (12–17)16 (12–19)0.58
Pre-onset mRS 0, n, %25 (83.3%)9 (75%)16 (88.9%)0.36
ASPECTS 9 or 10, n, %28 (93.3%)12 (100%)16 (88.9%)0.50
Pt on OMT, n, %13 (43.3%)5 (41.6%)8 (44.4%)1.0
Extracranial ICA severe stenosis/near-occlusion, n, %15 (50.0%)8 (66.7%)7 (38.9%)0.26
Extracranial ICA acute occlusion, n, %15 (50.0%)4 (33.3%)11 (61.1%)0.26
Tandem lesion, n, %8 (26.7%)1 (8.3%)7 (38.9%)0.099
Thrombolysis given, n, %10 (33.3%)2 (16.7%)8 (44.4%)0.23
Stroke mechanism
 H14 (46.7%)8 (66.7%)6 (33.3%)0.13
 E4 (13.3%)1 (8.3%)3 (16.7%)0.63
 H+E, n, %12 (40.0%)3 (25%)9 (50.0%)0.71
Affected side left, n, %16 (53.3%)4 (33.3%)12 (66.7%)0.13
Presentation to intervention time, min (median, Q1–Q3)NA105 (57.5–172.5)NANA
Proximal protection, n, %NA11 (91.7%)NANA
Thrombectomy performed, n, %NA3 (25%)NANA
Micronet-covered stent, n, %NA12 (100%)NANA
Puncture to recanalization time, min (median, Q1–Q3)NA64.5 (47.7–83.7)NANA
Recanalization outcome
 mTICI 2b/cNA2 (16.7%)NANA
 mTICI 3NA10 (83.3%)NANA
90-day mRS (0–2)11 (36.7%)11 (91.7%)0 (0.0%)
90-day mRS (3–5)17 (56.7%)1 (8.3%)16 (88.9%)
90-day mRS (6)2 (6.7%)0 (0.0%)2 (11.1%)0.51
Data are provided (median, Q1–Q3, or n, proportion) for clinical and lesion/stroke characteristics for entire study cohort (Total) and for the 2 groups (EMR-treated and EMR-untreated) AF – atrial fibrillation; ASPECTS – Alberta Stroke Program Early Computed Tomography Score; CAD – coronary artery disease; E – embolic; EMR – Emergency Mechanical Reperfusion; H – hemorrhagic; ICA – Internal Carotid Artery; NIHSS – National Institutes of Health Stroke Scale; mRS – modified Rankin Score; OMT – Optimal Medical Therapy; mTICI – modified Thrombolysis in Cerebral Infarction scale.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750