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 Dzierwa12ABDEF*, Magdalena Knapik234ABDEF, Łukasz Tekieli235ABDEF, Adam Mazurek23ABDEF, Małgorzata Urbańczyk-Zawadzka26BCD, Artur Klecha7ABD, Tomasz Kowalczyk7ABD, Teresa Koźmik7ABD, Łukasz Wiewiórka
2567ABD, Paweł Banyś6BCD, Ewa Węglarz25BC, Justyna Stefaniak8CD, Rafał T. Nizankowski9ADF, Iris Q. Grunwald1011ADEF, Piotr Musiałek23ABCDEF
DOI: 10.12659/MSM.938549
Med Sci Monit 2022; 28:e938549
Table 1 Characteristics of study patients and lesions.
| Total | EMR-treated | EMR-untreated | p | |
|---|---|---|---|---|
| No. of patients | 30 | 12 | 18 | |
| 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 | ||||
| H | 14 (46.7%) | 8 (66.7%) | 6 (33.3%) | 0.13 |
| E | 4 (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) | NA | 105 (57.5–172.5) | NA | NA |
| Proximal protection, n, % | NA | 11 (91.7%) | NA | NA |
| Thrombectomy performed, n, % | NA | 3 (25%) | NA | NA |
| Micronet-covered stent, n, % | NA | 12 (100%) | NA | NA |
| Puncture to recanalization time, min (median, Q1–Q3) | NA | 64.5 (47.7–83.7) | NA | NA |
| Recanalization outcome | ||||
| mTICI 2b/c | NA | 2 (16.7%) | NA | NA |
| mTICI 3 | NA | 10 (83.3%) | NA | NA |
| 90-day mRS (0–2) | 11 (36.7%) | 11 (91.7%) | 0 (0.0%) | <0.001 |
| 90-day mRS (3–5) | 17 (56.7%) | 1 (8.3%) | 16 (88.9%) | <0.001 |
| 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. | ||||