학술논문
Meniscus Sign in Patients with Anterior Circulation Large Vessel Occlusion Stroke does not Predict Outcome
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Academic Journal
Author
Source
Clinical Neuroradiology. March 2023, Vol. 33 Issue 1, p65, 8 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Introduction Advances in the techniques and devices used in endovascular treatment (EVT) of acute ischemic stroke patients with large vessel occlusion have led to significant improvements in angiographic and clinical [...]
Purpose The angiographic appearance of the occlusion site was suggested to influence outcomes of stroke patients with large vessel occlusion (LVO) who undergo endovascular treatment (EVT). We aimed to study the impact of the meniscus sign (MS) on outcomes of stroke patients with anterior circulation LVO. Methods Based on two prospective registries of acute ischemic stroke, we selected patients with carotid-T, Ml or M2 occlusion who underwent EVT. Clinical characteristics and outcomes were collected from the registries or from individual records. Two independent observers blinded to outcomes assessed the presence of MS in digital subtraction angiography before thrombectomy. Angiographic and clinical outcomes of patients with and without MS were compared. Results We included 903 patients, with median age of 78 years, 59.8% were male, median baseline NIHSS was 14 and 39.5% received intravenous thrombolysis. Patients with MS (n = 170, 18.8%) were more frequently female, presented with higher NIHSS scores and more frequently underwent intravenous thrombolysis. Presence of MS was significantly associated with cardioembolic etiology. Successful reperfusion, number of passes, first pass effect, procedural time, symptomatic intracerebral hemorrhage, in-hospital mortality and favorable 3-month functional outcome were similar in the groups of patients with and without MS. In the multivariable analyses, MS was not associated with successful reperfusion (odds ratio, OR=1.08, 95% confidence interval, CI=0.76-1.55), first pass effect (OR=0.96, 95%CI=0.48-1.92) or favorable 3-month outcome (OR= 1.40, 95%CI = 0.88-2.24). Conclusion The presence of MS in acute ischemic stroke patients with anterior circulation large vessel occlusion who undergo EVT does not appear to influence angiographic or clinical outcomes. Keywords Ischemic stroke * Thrombectomy * Endovascular * Digital subtraction angiography * Prognosis
Purpose The angiographic appearance of the occlusion site was suggested to influence outcomes of stroke patients with large vessel occlusion (LVO) who undergo endovascular treatment (EVT). We aimed to study the impact of the meniscus sign (MS) on outcomes of stroke patients with anterior circulation LVO. Methods Based on two prospective registries of acute ischemic stroke, we selected patients with carotid-T, Ml or M2 occlusion who underwent EVT. Clinical characteristics and outcomes were collected from the registries or from individual records. Two independent observers blinded to outcomes assessed the presence of MS in digital subtraction angiography before thrombectomy. Angiographic and clinical outcomes of patients with and without MS were compared. Results We included 903 patients, with median age of 78 years, 59.8% were male, median baseline NIHSS was 14 and 39.5% received intravenous thrombolysis. Patients with MS (n = 170, 18.8%) were more frequently female, presented with higher NIHSS scores and more frequently underwent intravenous thrombolysis. Presence of MS was significantly associated with cardioembolic etiology. Successful reperfusion, number of passes, first pass effect, procedural time, symptomatic intracerebral hemorrhage, in-hospital mortality and favorable 3-month functional outcome were similar in the groups of patients with and without MS. In the multivariable analyses, MS was not associated with successful reperfusion (odds ratio, OR=1.08, 95% confidence interval, CI=0.76-1.55), first pass effect (OR=0.96, 95%CI=0.48-1.92) or favorable 3-month outcome (OR= 1.40, 95%CI = 0.88-2.24). Conclusion The presence of MS in acute ischemic stroke patients with anterior circulation large vessel occlusion who undergo EVT does not appear to influence angiographic or clinical outcomes. Keywords Ischemic stroke * Thrombectomy * Endovascular * Digital subtraction angiography * Prognosis