دورية أكاديمية

Early neurological deterioration in patients with minor stroke due to isolated M2 occlusion undergoing medical management: a retrospective multicenter study

التفاصيل البيبلوغرافية
العنوان: Early neurological deterioration in patients with minor stroke due to isolated M2 occlusion undergoing medical management: a retrospective multicenter study
المؤلفون: Broccolini, Aldobrando, Brunetti, Valerio, Colò, Francesca, Alexandre, Andrea M, Valente, Iacopo, Falcou, Anne, Frisullo, Giovanni, Pedicelli, Alessandro, Scarcia, Luca, Scala, Irene, Rizzo, Pier Andrea, Bellavia, Simone, Camilli, Arianna, Milonia, Luca, Piano, Mariangela, Macera, Antonio, Commodaro, Christian, Ruggiero, Maria, Da Ros, Valerio, Bellini, Luigi, Lazzarotti, Guido A, Cosottini, Mirco, Caragliano, Armando A, Vinci, Sergio L, Gabrieli, Joseph D, Causin, Francesco, Panni, Pietro, Roveri, Luisa, Limbucci, Nicola, Arba, Francesco, Pileggi, Marco, Bianco, Giovanni, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Fasano, Antonio, Lafe, Elvis, Cavallini, Anna, Russo, Riccardo, Bergui, Mauro, Calabresi, Paolo, Della Marca, Giacomo
المساهمون: Broccolini, Aldobrando, Brunetti, Valerio, Colò, Francesca, Alexandre, Andrea M, Valente, Iacopo, Falcou, Anne, Frisullo, Giovanni, Pedicelli, Alessandro, Scarcia, Luca, Scala, Irene, Rizzo, Pier Andrea, Bellavia, Simone, Camilli, Arianna, Milonia, Luca, Piano, Mariangela, Macera, Antonio, Commodaro, Christian, Ruggiero, Maria, Da Ros, Valerio, Bellini, Luigi, Lazzarotti, Guido A, Cosottini, Mirco, Caragliano, Armando A, Vinci, Sergio L, Gabrieli, Joseph D, Causin, Francesco, Panni, Pietro, Roveri, Luisa, Limbucci, Nicola, Arba, Francesco, Pileggi, Marco, Bianco, Giovanni, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Fasano, Antonio, Lafe, Elvi, Cavallini, Anna, Russo, Riccardo, Bergui, Mauro, Calabresi, Paolo, Della Marca, Giacomo
سنة النشر: 2023
المجموعة: ARPI - Archivio della Ricerca dell'Università di Pisa
مصطلحات موضوعية: stroke, thrombectomy, thrombolysis
الوصف: BackgroundPatients with minor stroke and M2 occlusion undergoing best medical management (BMM) may face early neurological deterioration (END) that can lead to poor long-term outcome. In case of END, rescue mechanical thrombectomy (rMT) seems beneficial. Our study aimed to define factors relevant to clinical outcome in patients undergoing BMM with the possibility of rMT on END, and find predictors of END.MethodsPatients with M2 occlusion and a baseline National Institutes of Health Stroke Scale (NIHSS) score <= 5 that received either BMM only or rMT on END after BMM were extracted from the databases of 16 comprehensive stroke centers. Clinical outcome measures were a 90-day modified Rankin Scale (mRS) score of 0-1 or 0-2, and occurrence of END.ResultsAmong 10 169 consecutive patients with large vessel occlusion admitted between 2016 and 2021, 208 patients were available for analysis. END was reported in 87 patients that were therefore all subjected to rMT. In a logistic regression model, END (OR 3.386, 95% CI 1.428 to 8.032), baseline NIHSS score (OR 1.362, 95% CI 1.004 to 1.848) and a pre-event mRS score=1 (OR 3.226, 95% CI 1.229 to 8.465) were associated with unfavorable outcome. In patients with END, successful rMT was associated with favorable outcome (OR 4.549, 95% CI 1.098 to 18.851). Among baseline clinical and neuroradiological features, presence of atrial fibrillation was a predictor of END (OR 3.547, 95% CI 1.014 to 12.406).ConclusionPatients with minor stroke due to M2 occlusion and atrial fibrillation should be closely monitored for possible worsening during BMM and, in this case, promptly considered for rMT.
نوع الوثيقة: article in journal/newspaper
اللغة: English
العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36977569; info:eu-repo/semantics/altIdentifier/wos/WOS:000969282300001; journal:JOURNAL OF NEUROINTERVENTIONAL SURGERY; https://hdl.handle.net/11568/1185087Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85152678255
DOI: 10.1136/jnis-2023-020118
الإتاحة: https://doi.org/10.1136/jnis-2023-020118Test
https://hdl.handle.net/11568/1185087Test
رقم الانضمام: edsbas.A5194175
قاعدة البيانات: BASE