Cor Vasa 2018, 60(1):e30-e34 | DOI: 10.1016/j.crvasa.2017.12.010

Clinical outcomes of acute ischemic stroke patients treated by direct catheter-based trombectomy depending on their baseline characteristics

Jana Vavrová^a,*, Boris Kožnar^a, Tomáš Peisker^b, Peter Vaško^b, Filip Roháč^a, Josef Kroupa^a, Ivana Štětkářová^b, Petr Widimský^a

^a III. interní klinika-kardiologická, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

^b Neurologická klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

Background: Direct catheter-based thrombectomy (d-CBT) was proven to be an effective treatment for proximal occlusions of the major intracranial arteries in acute stroke patients. The aim of this study was to compare clinical outcomes of patients treated by d-CBT depending on their baseline characteristics.

Methods: A single center, prospective, observational registry of consecutive patients (pts) treated by d-CBT for an acute ischemic stroke. The degree of dependence after a stroke was measured by the modified Rankin scale (mRS) at 3 months follow-up and pts were divided into 2 subgroups based on functional independence/dependence (mRS 0-2 vs. 3-6).

Results: A total of 111 consecutive patients (mean age 65.9 ys, men 55%) have been enrolled. A favorable outcome (mRS ≤ 2 at 3 months) was reached in 39.8% (44 pts). The pts with favorable outcome (mRS ≤ 2) compared to pts with poor outcome (mRS 3-6) were younger (61 ys vs. 70 ys, p < 0.01), had higher prevalence of cigarette smoking (45.5% vs. 25.4%, p < 0.002) and had lower prevalence of known atrial fibrillation (25% vs. 53.7%, p < 0.001). There were no significant differences between the subgroups in: sex (men 50% vs. 58%, p = 0.27), body mass index (27.8 vs. 29.2, p = 0.21), arterial hypertension (70.5% vs. 77.6%, p = 0.26), diabetes mellitus (15.9% vs. 25.4%, p = 0.15), chronic kidney disease (11.4% vs. 22.4%, p = 0.08) and NIHSS on admission (15 vs. 18, p = 0.69).

Conclusions: Mechanical thrombectomy achieved better clinical results in younger patients, in smokers and in patients with stroke not caused by atrial fibrillation.

Keywords: Acute ischemic stroke; Atrial fibrillation; Clinical outcomes; Direct catheter-based trombectomy; Endovascular treatment

Received: August 30, 2017; Revised: December 19, 2017; Accepted: December 19, 2017; Published: February 1, 2018  Show citation