Abstract

Background: Endovascular treatment (EVT) has become the standard treatment for large vessel occlusion (LVO) in acute ischemic stroke. However, results on long-term clinical outcomes are lacking. Objective: We sought to assess the 5-year functional outcome of patients with acute LVO in anterior circulation undergoing EVT. Methold This study was an observational, nationwide registry of consecutive patients aged 18 years or older who received EVT for acute LVO in anterior circulation in 27 comprehensive stroke centers across 12 provinces in China. The primary outcome was the proportion of good functional outcome defined as modified Rankin Scale scores (mRS) of 2 or less at 5 years. Secondary outcomes included the proportion of patients with excellent clinical outcome (mRs0-1), all-cause mortality and risk of stroke recurrence at 5 years. Results: A total of 807 patients were recruited into the study. Of these, 642 patients (79.6%) had 5-year follow-up data. Both the proportions of good outcome (40.7% VS 43.2%, P=0.321).and excellent outcome (29.6% VS 27.0%, P=0.278) at 5 years were similar to the proportions at 90 days after stroke; The cumulative 5-year mortality (47.0% VS 24.7%, P<0.001) and stroke recurrence rate (19.9% VS 1.6%, P<0.001) were significantly higher than rates at 90 days, and 66.4% of the stroke recurrent patients died at 5 years. Multivariate analyses identified increasing age, residual disability at 90 days and stroke recurrence were predictors for good functional outcome and the increased mortality risk at 5 years.

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