Mechanical Thrombectomy in Prestroke Disability: Data From the Italian Endovascular Stroke Registry.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Naldi Andrea, D'Agata Federico, Pracucci Giovanni, Saia Valentina, Cavallo Roberto, Castellano Davide, Sallustio Fabrizio, Casetta Ilaria, Fainardi Enrico, Da Ros Valerio, Maestrini Ilaria, Vinci Sergio Lucio, La Spina Paolino, Limbucci Nicola, Nencini Patrizia, Lafe Elvis, Longoni Marco, Bracco Sandra, Tassi Rossana, Vallone Stefano, Bigliardi Guido, Cerrato Paolo, Castellan Lucio, Del Sette Massimo, Menozzi Roberto, Pezzini Alessandro, Merolla Stefano, Forlivesi Stefano, Nappini Sergio, Loizzo Nicola Davide, Saletti Andrea, Azzini Cristiano, Lazzarotti Guido Andrea, Giannini Nicola, Romano Daniele Giuseppe, Napoletano Rosa, Burdi Nicola, Boero Giovanni, Comai Alessio, Dall'Ora Elisa, Cavasin Nicola, Critelli Adriana, Plebani Mauro, Cappellari Manuel, Zimatore Domenico Sergio, Petruzzellis Marco, Biraschi Francesco, Nicolini Ettore, Sanna Antioco, Tassinari Tiziana, Puglielli Edoardo, Casalena Alfonsina, Gallesio Ivan, Ferrandi Delfina, Filauri Pietro, Sacco Simona, Paladini Adriana, Rizzo Annalisa, Besana Michele, Giossi Alessia, Pavia Marco, Invernizzi Paolo, Amistà Pietro, Russo Monia, Filizzolo Marco, Mannino Marina, Galvano Gianluca, Saracco Eleonora Lidia, Bergui Mauro, Mangiafico Salvatore, Toni Danilo, IRETAS Collaborators
Аннотация
METHODS: We analyzed data collected between 2015 and 2021, comparing functional outcomes (mRS), symptomatic intracerebral hemorrhage, and recanalization rates (Thrombolysis in Cerebral Infarction) at 90 days post-MT in patients with prestroke mRS score of 3 to 4 versus 0 to 2. A good outcome was defined as no change in the mRS score from baseline. Subgroup analysis was stratified by age.
RESULTS: A total of 11.411 (96%) patients with prestroke mRS score of 0 to 2 and 477 (4%) patients with prestroke mRS score of 3 to 4 were included. Compared with patients with a baseline mRS score 0 to 2, those with mRS score 3 to 4 were older (82 versus 75 years; P<0.001) and predominantly female (71.7% versus 53%; P<0.001). The maintenance of the same mRS score after MT was observed in 100 (23.3%) patients with prestroke mRS score 3 to 4, compared with 2332 (22.1%) patients with mRS score 0 to 2 (P=0.556). Mortality was significantly higher in the mRS score 3 to 4 group (n=159 [37.1%] versus n=1939 [18.4%]; P<0.001). Successful recanalization (Thrombolysis in Cerebral Infarction score ≥2b) was lower in the mRS score 3 to 4 group (n=333 [71.6%] versus n=8706 [77.7%]; P=0.002), while no significant differences in symptomatic intracerebral hemorrhage were found. The benefit of MT was maintained in patients aged 80 to 85 and over 85 years with prestroke mRS score 3 to 4, although mortality remained higher.
CONCLUSIONS: Our data suggest that prestroke disability does not imply less chance of returning to prestroke conditions after MT, even in octogenarians, despite higher mortality and lower recanalization rate. More data are warranted to better understand the benefit of MT in this subgroup of patients.