Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window
Objective To evaluate the long⁃term prognosis in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window (> 24 h) who received endovascular treatment (EVT) combined with best medical treatment (BMT), compared to those treated with BMT alone...
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| Format: | Article |
| Language: | English |
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Tianjin Huanhu Hospital
2024-11-01
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| Series: | Chinese Journal of Contemporary Neurology and Neurosurgery |
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| Online Access: | http://www.cjcnn.org/index.php/cjcnn/article/view/2954 |
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| author | LIU Shu⁃ling XU Yong⁃bo LI Yang WANG Si⁃fei LUO Lei⁃lei WEI Ming |
| author_facet | LIU Shu⁃ling XU Yong⁃bo LI Yang WANG Si⁃fei LUO Lei⁃lei WEI Ming |
| author_sort | LIU Shu⁃ling |
| collection | DOAJ |
| description | Objective To evaluate the long⁃term prognosis in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window (> 24 h) who received endovascular treatment (EVT) combined with best medical treatment (BMT), compared to those treated with BMT alone. Methods This study included 158 patients from a prospective cohort of acute ischemic stroke due to large vessel occlusion were conducted at Tianjin Huanhu Hospital from November 2021 to July
2023. The 158 patients with anterior circulation large vessel occlusion were divided into received EVT combined with BMT (EVT group, n = 70) and received BMT alone (BMT group, n = 88). Long ⁃ term neurological prognosis was assessed using the modified Rankin Scale (mRS) 12 months after onset.
Univariate and multivariate stepwise Logistic regression analyses were useded to investigated the risk factors of long⁃term neurological prognosis. Sensitivity analyses were performed using propensity score matching
(PSM) and multiple imputation (MI). Results Logistic regression analysis showed that EVT was a protective factor for good long ⁃term neurological prognosis (mRS score ≤ 2; OR = 3.110, 95%CI: 1.460- 6.620, P = 0.003), increasing age (OR = 0.955, 95%CI: 0.924-0.987; P = 0.007) and hypertension (OR = 0.418, 95%CI: 0.187-0.936; P = 0.034) were risk factors. In the sensitivity analyses of the primary outcome, both the PSM and MI datasets showed that the proportion of patients with a good long ⁃ term neurological prognosis was significantly higher in the EVT group compared to the BMT group (PSM: aOR = 3.610, 95%CI: 1.370-9.550, P = 0.010; MI: aOR = 3.870, 95%CI: 1.780-8.440, P = 0.000). The results were consistent with the main analysis. Conclusions Compared to BMT group, EVT group patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window was demonstrated a significantly better long⁃term neurological prognosis. |
| format | Article |
| id | doaj-art-d79eac220c284b6eaba0e6a2113c82ee |
| institution | OA Journals |
| issn | 1672-6731 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Tianjin Huanhu Hospital |
| record_format | Article |
| series | Chinese Journal of Contemporary Neurology and Neurosurgery |
| spelling | doaj-art-d79eac220c284b6eaba0e6a2113c82ee2025-08-20T02:37:47ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312024-11-012411933942DOI:10.3969/j.issn.1672⁃6731.2024.11.010Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time windowLIU Shu⁃ling0XU Yong⁃bo1LI Yang2WANG Si⁃fei3LUO Lei⁃lei4WEI Ming5Department of Neurosurgery, Tianjin Huanhu Hospital; Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300350, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital; Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300350, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital; Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300350, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital; Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300350, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital; Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300350, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital; Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300350, ChinaObjective To evaluate the long⁃term prognosis in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window (> 24 h) who received endovascular treatment (EVT) combined with best medical treatment (BMT), compared to those treated with BMT alone. Methods This study included 158 patients from a prospective cohort of acute ischemic stroke due to large vessel occlusion were conducted at Tianjin Huanhu Hospital from November 2021 to July 2023. The 158 patients with anterior circulation large vessel occlusion were divided into received EVT combined with BMT (EVT group, n = 70) and received BMT alone (BMT group, n = 88). Long ⁃ term neurological prognosis was assessed using the modified Rankin Scale (mRS) 12 months after onset. Univariate and multivariate stepwise Logistic regression analyses were useded to investigated the risk factors of long⁃term neurological prognosis. Sensitivity analyses were performed using propensity score matching (PSM) and multiple imputation (MI). Results Logistic regression analysis showed that EVT was a protective factor for good long ⁃term neurological prognosis (mRS score ≤ 2; OR = 3.110, 95%CI: 1.460- 6.620, P = 0.003), increasing age (OR = 0.955, 95%CI: 0.924-0.987; P = 0.007) and hypertension (OR = 0.418, 95%CI: 0.187-0.936; P = 0.034) were risk factors. In the sensitivity analyses of the primary outcome, both the PSM and MI datasets showed that the proportion of patients with a good long ⁃ term neurological prognosis was significantly higher in the EVT group compared to the BMT group (PSM: aOR = 3.610, 95%CI: 1.370-9.550, P = 0.010; MI: aOR = 3.870, 95%CI: 1.780-8.440, P = 0.000). The results were consistent with the main analysis. Conclusions Compared to BMT group, EVT group patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window was demonstrated a significantly better long⁃term neurological prognosis.http://www.cjcnn.org/index.php/cjcnn/article/view/2954ischemic stroke; arterial occlusive diseases; thrombectomy; prognosis; logistic models; kaplan⁃meier estimate |
| spellingShingle | LIU Shu⁃ling XU Yong⁃bo LI Yang WANG Si⁃fei LUO Lei⁃lei WEI Ming Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window Chinese Journal of Contemporary Neurology and Neurosurgery ischemic stroke; arterial occlusive diseases; thrombectomy; prognosis; logistic models; kaplan⁃meier estimate |
| title | Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window |
| title_full | Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window |
| title_fullStr | Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window |
| title_full_unstemmed | Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window |
| title_short | Long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window |
| title_sort | long⁃term prognosis of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion presenting beyond the conventional time window |
| topic | ischemic stroke; arterial occlusive diseases; thrombectomy; prognosis; logistic models; kaplan⁃meier estimate |
| url | http://www.cjcnn.org/index.php/cjcnn/article/view/2954 |
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