Value of Ultrasound Diagnostics in Predicting Ischemic Stroke Outcomes after Different Reperfusion Therapies

Abstract

Acute ischemic stroke (AIS) is associated with high mortality, disability and economic expenses. Despite significant progress in the treatment of AIS using endovascular methods, it is not always possible to obtain good results. In the current literature, a small number of studies are devoted to predicting outcomes in patients with AIS who received various types of treatment.This prospective cohort study included 460 patients who underwent thrombolytic therapy, thromboextraction, combination of thromboextraction with stenting or thrombolytic therapy.The relationship between clinical and functional results at the early stages after intervention was assessed with potential predictors, among which the ultrasonic characteristics of extra- and intracranial arteries were analyzed.Complete or partial reperfusion was obtained in 61,7 % of the examined patients. A higher efficiency of endovascular methods compared to thrombolytic therapy was noted (99,5 % vs 33,5 % respectively). The baseline NIHSS and Rankin scores did not show a high predictive valuey for early outcomes, that caused the necessary for searching instrumental predictors. Patients with significant stenosis of the internal carotid artery or vertebral artery had significantly worse clinical and functional outcomes, including the mRS scale. The proportion of poor early outcomes in patients with significant stenosis was significantly lower in the endovascular treatment groups compared to the thrombolytic therapy group. Multiple regression analysis showed that the outcome of AIS is influenced by the level of cerebral arterial involvement as well as lesion size with a threshold value of more than 2 cm.