Dataset Information

Outcome and Treatment Effects in Stroke Associated with Acute Cervical ICA Occlusion.

ABSTRACT:

Background

Endovascular therapy (EVT) with stent retrievers in addition to i.v. thrombolysis (IVT) has proven effective in acute stroke patients with middle cerebral artery (MCA, M1 segment) and distal internal carotid artery (ICA) occlusion. Limited data exist concerning acute cervical ICA occlusion, either alone or in combination with intracranial ICA occlusion (tandem occlusion). Therefore we analyzed outcome and treatment effects in stroke associated with cervical ICA occlusion, with specific focus on the impact of intracranial ICA or M1 patency.

Methods

Seventy-eight patients with cervical ICA occlusion from our local stroke unit registry were analyzed retrospectively. Thrombolysis in Cerebral Infarction (TICI) classification, infarct size, modified Rankin scale (mRS), symptomatic intracerebral hemorrhage (ICH), and death were assessed as outcome parameters.

Results

Forty-three patients had isolated cervical ICA occlusion whereas 35 patients presented with extra-/intracranial tandem occlusion. Patients underwent IVT alone (n = 23), combined IVT/EVT (n = 28) or no treatment (n = 27). Treated and untreated patients with tandem occlusion had a worse outcome after 90 days compared to isolated cervical occlusion (OR for moderate outcome 0.29, 0.27-0.88, p = 0.01). Additional EVT improved outcome in patients with tandem occlusion (OR for moderate outcome: 15.43, 1.60-148.90, p = 0.008) but not isolated cervical occlusion (OR 1.33, 0.38-11.60, NS).

Conclusions

In contrast to tandem occlusion, stroke outcome in patients with isolated cervical ICA occlusion was generally more benign and not improved by combined IVT/EVT compared to IVT alone. Intracranial vessel patency may be critical for treatment decision in acute cervical ICA occlusion.

SUBMITTER: Gliem M

PROVIDER: S-EPMC5231377 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Outcome and Treatment Effects in Stroke Associated with Acute Cervical ICA Occlusion.

Gliem Michael M Lee John-Ih JI Barckhan Aurica A Turowski Bernd B Hartung Hans-Peter HP Jander Sebastian S

PloS one 20170112 1

<h4>Background</h4>Endovascular therapy (EVT) with stent retrievers in addition to i.v. thrombolysis (IVT) has proven effective in acute stroke patients with middle cerebral artery (MCA, M1 segment) and distal internal carotid artery (ICA) occlusion. Limited data exist concerning acute cervical ICA occlusion, either alone or in combination with intracranial ICA occlusion (tandem occlusion). Therefore we analyzed outcome and treatment effects in stroke associated with cervical ICA occlusion, with ...[more]

PMID: 28081270

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Dataset Information

Outcome and Treatment Effects in Stroke Associated with Acute Cervical ICA Occlusion.

Background

Methods

Results

Conclusions

Publications

Outcome and Treatment Effects in Stroke Associated with Acute Cervical ICA Occlusion.

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