Abstract | BACKGROUND AND PURPOSE: METHODS: We identified 201 patients with middle cerebral artery occlusion. Patients with other occlusive lesions were excluded. Baseline clinical/radiological characteristics, procedural outcomes (including thrombolysis in cerebral infarction scores), clinical outcome scores (modified Rankin scores), and final infarct volumes on diffusion weighted imaging were retrospectively analyzed from a prospectively collected database. Favorable outcome is defined as 90-day modified Rankin score≤2. RESULTS: Successful recanalization (thrombolysis in cerebral infarction grade 2b or 3) was achieved in 63.2% and favorable outcomes in 46% of cases. Mean infarct volume was 50.1 mL in recanalized versus 133.9 mL in non-recanalized patients (P<0.01) and 40.4 mL in patients with favorable outcomes versus 111.8 in patients with unfavorable outcomes (P<0.01). In multivariate analysis, thrombolysis in cerebral infarction≥2b, baseline National Institute of Health Stroke Scale, Alberta Stroke Program Early Computed Tomography scores, and age were identified as independent predictors of outcome. However, when infarct volumes were included in the analysis only final infarct volume and age remained significantly associated. CONCLUSIONS: Successful recanalization leads to improved functional outcomes through a reduction in final infarct volumes. In our series, age and final infarct volume but not recanalization were found to be independent predictors of outcome, supporting the use of final infarct volume as surrogate marker of outcome in acute stroke trials.
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Authors | Syed F Zaidi, Amin Aghaebrahim, Xabier Urra, Mouhammad A Jumaa, Brian Jankowitz, Maxim Hammer, Raul Nogueira, Michael Horowitz, Vivek Reddy, Tudor G Jovin |
Journal | Stroke
(Stroke)
Vol. 43
Issue 12
Pg. 3238-44
(Dec 2012)
ISSN: 1524-4628 [Electronic] United States |
PMID | 23160876
(Publication Type: Journal Article)
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Topics |
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Brain Ischemia
(pathology, therapy)
- Cerebral Revascularization
- Databases, Factual
- Endovascular Procedures
- Female
- Follow-Up Studies
- Humans
- Infarction, Middle Cerebral Artery
(pathology, therapy)
- Logistic Models
- Magnetic Resonance Imaging
- Male
- Mechanical Thrombolysis
- Middle Aged
- Multivariate Analysis
- Predictive Value of Tests
- Retrospective Studies
- Treatment Outcome
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