학술논문
Endovascular treatment in anterior circulation stroke beyond 6.5 hours after onset or time last seen well: results from the MR CLEAN Registry
Document Type
article
Author
Robert J van Oostenbrugge; Wim H van Zwam; Maarten Uyttenboogaart; Yvo B W E M Roos; Jeannette Hofmeijer; Jasper M Martens; Ivo G H Jansen; Ludo F M Beenen; Hester F Lingsma; Albert J Yoo; Diederik W J Dippel; Charles B L M Majoie; Olvert A Berkhemer; Bart J Emmer; Marianne A A van Walderveen; Sjoerd F M Jenniskens; Wouter J Schonewille; Jan Albert Vos; Julie Staals; Geert J Lycklama à nijeholt; Jelis Boiten; Rob H Lo; Ewoud J Van Dijk; René J Dallinga; Koos Keizer; Heleen M Den Hertog; Katinka R van Kranendonk; Kilian M Treurniet; Esmee Venema; Bob Roozenbeek; Robin Lemmens; Robert-Jan B Goldhoorn; Ido R van den Wijngaard; Jonathan M Coutinho; Stefan D Roosendaal; Joost Bot; Naziha El Ghannouti; Martin Sterrenberg; Wilma Pellikaan; Rita Sprengers; Marjan Elfrink; Joke de Meris; Tamara Vermeulen; Annet Geerlings; Gina van Vemde; Tiny Simons; Gert Messchendorp; Hester Bongenaar; Karin Bodde; Sandra Kleijn; Jasmijn Lodico; D Jeurrissen; Erna Bos; Yvonne Drabbe; Berber Zweedijk; Daan Muijres; J Huguet; Marieke A Mens; Manon Kappelhof; Heitor Alves; Manon L Tolhuisen; Alida A Postma; Reinoud P H Bokkers; Maxim J H L Mulder; Kars C J Compagne; Josje Brouwer; Wouter H Hinsenveld; Marieke J H Wermer; J de Vries; Julia van Tuijl; Jo P Peluso; Puck Fransen; Leo A M Aerden; Omid Eschgi; Tobien H C M L Schreuder; Roel J J Heijboer; Lonneke S F Yo; Emiel J C Sturm; Paul J A M Brouwers; Marieke E S Sprengers; René van den Berg; Pieter-Jan van Doormaal; Anton Meijer; Elyas Ghariq; Dick Gerrits; Wouter Dinkelaar; Auke P A Appelman; Bas Hammer; Sjoert Pegge; Anouk van der Hoorn; Saman Vinke; Michelle Simons; Marjolein Vossers; Nynke Nicolaij; Hanneke Droste; Maureen Wollaert; Sabrina Verheesen; Michelle Sandiman; Nicoline Aaldering; Jocova Vervoort; Eva Ponjee; Sharon Romviel; Annick J Weterings; Lieve M Schupp; Sabine Collette; Natalie E LeCouffe; Praneeta R Konduri; Haryadi Prasetya; Nerea Arrarte-Terreros; Lucas A Ramos; C Lukas; Luuk Dekker; F Anne V Pirson; Adriaan C G M van Es; Sanne J den Hartog; Sebastiaan F de Bruijnl; H van Dijk; Bart van der Worp; D Boogaarts Hieronymus; Paul L M de Kort; Jan S P van den Berg; Boudewijn A A M van Hasselt; Bas F W van der Kallen; P Marc; G van Proosdij;; Menno Krietemeijer; Roger R M Harmsma; M M Anna Boers; P F C Groot; Eleonora L F Kirkels; Eva J H F Voogd; Adrien E D Groot
Source
Stroke and Vascular Neurology, Vol , Iss
Subject
Language
English
ISSN
2059-8696
Abstract
Background Randomised controlled trials with perfusion selection have shown benefit of endovascular treatment (EVT) for ischaemic stroke between 6 and 24 hours after symptom onset or time last seen well. However, outcomes after EVT in these late window patients without perfusion imaging are largely unknown. We assessed their characteristics and outcomes in routine clinical practice.Methods The Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, multicentre study in the Netherlands, included patients with an anterior circulation occlusion who underwent EVT between 2014 and 2017. CT perfusion was no standard imaging modality. We used adjusted ordinal logistic regression analysis to compare patients treated within versus beyond 6.5 hours after propensity score matching on age, prestroke modified Rankin Scale (mRS), National Institutes of Health Stroke Scale, Alberta Stroke Programme Early CT Score (ASPECTS), collateral status, location of occlusion and treatment with intravenous thrombolysis. Outcomes included 3-month mRS score, functional independence (defined as mRS 0–2), and death.Results Of 3264 patients who underwent EVT, 106 (3.2%) were treated beyond 6.5 hours (median 8.5, IQR 6.9–10.6), of whom 93 (87.7%) had unknown time of stroke onset. CT perfusion was not performed in 87/106 (80.2%) late window patients. Late window patients were younger (mean 67 vs 70 years, p