Outcomes of endovascular treatment for acute anterior circulation ischemic stroke: Intracranial atherosclerotic versus cardioembolic stroke

Abstract

Objective To compare the outcomes of endovascular treatment between intracranial large artery atherosclerosis stroke (LAA) and cardioembolic stroke (CE) in Chinese patients with acute anterior circulation ischemic stroke. Methods Patients with acute anterior circulation ischemic stroke treated with the Solitaire stent retriever were enrolled. The patients were divided into either a LAA group or a CE group according to etiological subtype. The outcomes were compared between 2 groups. Multivariable logistic regression analysis was used to determine the independent risk factors for poor outcome (defined as the modified Rankin Scale score >2 at 90 d after onset). Results A total of 126 patients were enrolled in the study, including 62 (49.2%) in the LAA group and 64 (50.8%) in the CE group. The proportions of poor outcome at 90 d (59.0% vs. 41.0%; χ2=5.482, P=0.019) and symptomatic intracerebral hemorrhage at 72 h (12.5% vs. 1.6%; Fisher exact test P=0.033) in the CE group were significantly higher than those in the LAA group. Multivariate logistic regression analysis showed that high baseline National Institutes of Health Stroke Scale scores was independently associated with poor outcome (odds ratio [OR] 1.119, 95% confidence interval [CI] 1.026-1.221; P=0.011), good collateral circulation was was independently associated with good outcome (OR 0.227, 95% CI 0.097-0.788; P=0.016), and etiological subtype was not independently associated with outcome (OR 1.280, 95% CI 0.454-3.633; P=0.630). Conclusion Etiological subtype is not associated with outcome in patients with acute anterior circulation ischemic stroke treated with the Solitaire stent retriever. Key words: Stroke; Brain Ischemia; Endovascular Procedures; Thrombectomy; Stents; Intracranial Arteriosclerosis; Embolism; Treatment Outcome