TY - JOUR
T1 - Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke
T2 - Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands
AU - Goldhoorn, Robert-Jan B.
AU - Mulder, Maxim J. H. L.
AU - Jansen, Ivo G. H.
AU - van Zwam, Wim H.
AU - Staals, Julie
AU - van der Lugt, Aad
AU - Dippel, Diederik W. J.
AU - Lingsma, Hester F.
AU - Vos, Jan Albert
AU - Boiten, Jelis
AU - van den Wijngaard, Ido R.
AU - Majoie, Charles B. L. M.
AU - Roos, Yvo B. W. E. M.
AU - van Oostenbrugge, Robert J.
AU - Schonewille, Wouter J.
AU - Coutinho, Jonathan M.
AU - Wermer, Marieke J. H.
AU - van Walderveen, Marianne A. A.
AU - Hofmeijer, Jeannette
AU - Martens, Jasper M.
AU - Nijeholt, Geert J. Lycklama A.
AU - Roozenbeek, Bob
AU - Emmer, Bart J.
AU - de Bruijn, Sebastiaan F.
AU - van Dijk, Lukas C.
AU - van der Worp, H. Bart
AU - Lo, Rob H.
AU - van Dijk, Ewoud J.
AU - Boogaarts, Hieronymus D.
AU - de Kort, Paul L. M.
AU - Peluso, Jo J. P.
AU - van den Berg, Jan S. P.
AU - van Hasselt, Boudewijn A. A. M.
AU - Aerden, Leo A. M.
AU - Dallinga, Rene J.
AU - Uyttenboogaart, Maarten
AU - Eshghi, Omid
AU - Schreuder, Tobien H. C. M. L.
AU - Heijboer, Roel J. J.
AU - Keizer, Koos
AU - Yo, Lonneke S. F.
AU - den Hertog, Heleen M.
AU - Sturm, Emiel J. C.
AU - Sprengers, Marieke E. S.
AU - Jenniskens, Sjoerd F. M.
AU - Postma, Alida
AU - Hinsenveld, Wouter
AU - Groot, P. F. C.
AU - MR CLEAN Registry Investigators
N1 - Funding Information:
Funding Disclosure: This work was supported by TWIN Foundation, Erasmus MC University Medical Center, Maastricht University Medical Center, and Academic Medical Center, Amsterdam.
Publisher Copyright:
© 2018
PY - 2019/3
Y1 - 2019/3
N2 - Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score = 6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT. Materials and Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Minor ischemic stroke was defined as baseline NIHSS score of 5 or less. Primary outcome is the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes include symptomatic intracranial hemorrhage (sICH) and mortality. Findings: Seventy-one (5.5%) patients had a NIHSS score of 5 or less. Functional independence (mRS 0-2 at 90 days) was reached in 75% of these patients, compared to 40% of patients with NIHSS score of 6 or more. sICH occurred in 4% of patients, of which 1% occurred peri-interventionally. Death occurred in 6% of patients. Conclusions: Patients with minor ischemic stroke with an intracranial proximal arterial occlusion of the anterior circulation who underwent EVT have a high chance of favorable outcome and appear to have low occurrence of treatment-related sICH. Therefore, our results encourage the use of EVT for minor ischemic stroke in the absence of effect estimates from controlled studies.
AB - Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score = 6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT. Materials and Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Minor ischemic stroke was defined as baseline NIHSS score of 5 or less. Primary outcome is the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes include symptomatic intracranial hemorrhage (sICH) and mortality. Findings: Seventy-one (5.5%) patients had a NIHSS score of 5 or less. Functional independence (mRS 0-2 at 90 days) was reached in 75% of these patients, compared to 40% of patients with NIHSS score of 6 or more. sICH occurred in 4% of patients, of which 1% occurred peri-interventionally. Death occurred in 6% of patients. Conclusions: Patients with minor ischemic stroke with an intracranial proximal arterial occlusion of the anterior circulation who underwent EVT have a high chance of favorable outcome and appear to have low occurrence of treatment-related sICH. Therefore, our results encourage the use of EVT for minor ischemic stroke in the absence of effect estimates from controlled studies.
KW - Ischemic stroke
KW - endovascular treatment
KW - minor symptoms
KW - large vessel oclusion
KW - LARGE VESSEL OCCLUSION
KW - INTRAARTERIAL TREATMENT
KW - ANTERIOR CIRCULATION
KW - SCALE SCORE
KW - THERAPY
KW - MILD
KW - THROMBECTOMY
KW - ANGIOGRAPHY
KW - TRIAL
U2 - 10.1016/j.jstrokecerebrovasdis.2018.10.029
DO - 10.1016/j.jstrokecerebrovasdis.2018.10.029
M3 - Article
C2 - 30527790
SN - 1052-3057
VL - 28
SP - 542
EP - 549
JO - Journal of Stroke & Cerebrovascular Diseases
JF - Journal of Stroke & Cerebrovascular Diseases
IS - 3
ER -