Abstract
BackgroundWe aimed to assess the safety and efficacy of endovascular treatment (EVT) in patients with anterior circulation emergent large vessel occlusion (ELVO) beyond 6 h from symptom onset in a real-world cohort of patients in China.MethodsWe retrospectively examined 305 patients with anterior circulation ELVO treated with EVT. Patients were divided into two groups: treated with known onset within 6 h (n = 238) and beyond 6 h (n = 67). Multivariable logistic regression and ordinal shift analyses were used to evaluate the associations between onset-to-groin puncture time and safety and efficacy outcomes.ResultsTreatment beyond 6 h was not associated with symptomatic intracranial hemorrhage within 48 h (sICH; odds ratio [OR] 2.03, 95% confidence interval [CI] 0.48–8.57, p = 0.334), in-hospital mortality (OR 1.95, 95% CI 0.48–7.91, p = 0.348), successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b or 3; OR 0.73, 95% CI 0.31–1.73, p = 0.470), favorable functional outcome (modified Rankin Scale score 0–2; OR 0.55, 95% CI 0.25–1.23, p = 0.145), and functional improvement (modified Rankin Scale shift by 1-point decrease; common OR 0.80, 95%CI 0.45–1.42, p = 0.450) at 3 months compared with treatment within 6 h. Futher interaction analysis showed that stroke etiology did not modify the associations between onset-to-groin puncture time and outcomes (p > 0.05).ConclusionsIn this real-world study, after careful assessment, EVT beyond 6 h from known stroke onset was safe, effective and had comparable short-term outcomes to EVT within 6 h.
Highlights
We aimed to assess the safety and efficacy of endovascular treatment (EVT) in patients with anterior circulation emergent large vessel occlusion (ELVO) beyond 6 h from symptom onset in a real-world cohort of patients in China
Patients Based on the Nanjing First Hospital Stroke (NFHS) Registry Program [14], we performed a retrospective review of consecutively recruited stroke patients with anterior circulation ELVO treated with EVT between January 2016 and February 2020
Patients admitted within 6 h of stroke onset were treated with EVT if they fulfilled the following criteria: 1) 18 years or older; 2) anterior circulation ELVO confirmed by CT angiography (CTA) or MR
Summary
We aimed to assess the safety and efficacy of endovascular treatment (EVT) in patients with anterior circulation emergent large vessel occlusion (ELVO) beyond 6 h from symptom onset in a real-world cohort of patients in China. The safety and effectiveness of endovascular treatment (EVT) for acute ischemic stroke (AIS) from anterior circulation emergent large vessel occlusion (ELVO) within 6 h after the onset of symptoms have been fully confirmed by recent large randomized controlled trials [1,2,3,4,5]. Since the main etiology of ischemic stroke in Asian and Western populations are different, in that the Asian population mainly manifested with a higher proportion of large artery atherosclerosis (LAA) stroke [11,12,13], it is necessary to conduct a real-world study on patients with EVT beyond 6 h in the Asia population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
