Frequency and outcome of total anterior circulation strokes without intracranial large-vessel occlusion
Por:
Giralt-Steinhauer, E, Ois, A, Abilleira, S, Urra, X, Cardona-Portela, P, Gomis, M, Castellanos, M, Molina, C, Marti-Fabregas, J, Pellise, A, Canovas, D, Gomez-Choco, M, Kuprinski, J, Cocho, D, Roquer, J
Publicada:
1 ene 2017
Resumen:
Background and purpose: The percentage of patients with clinical total anterior circulation infarct (TACI) syndrome treated with reperfusion therapies in the absence of intracranial large-vessel occlusion (ILVO) was determined and their characteristics and outcome are described.
Methods: Data from a population-based, prospective, externally audited registry of all stroke patients treated with intravenous thrombolysis (IVT) and endovascular therapies in Catalonia from January 2011 to December 2013 were used. Patients with a baseline TACI and initial stroke severity measured by the National Institute of Health Stroke Scale (NIHSS) >= 8, evaluated less than 4.5 h post-onset, for whom a vascular study prior to treatment was available (n = 1070) were selected. Clinical characteristics, outcome and radiological data for patients treated with IVT alone (n = 605) were compared between those with detected ILVO (n = 474) and non-ILVO patients (n = 131).
Results: A total of 1070 patients met study criteria; non-ILVO was found in 131 (12.2%). Analysing the 605 patients treated only with IVT, no significant differences were found between non-ILVO and ILVO patients in age, sex, risk factors, time-to-treatment and type of radiological studies performed. Although non-ILVO patients had lower initial stroke severity (P < 0.001) and a better prognosis (P = 0.001), 51.3% had a poor outcome and 16% were deceased at 90 days. In 66.4% of patients without ILVO, a recent anterior territorial infarct was detected.
Conclusions: Intracranial artery patency was observed in 12.2% of TACI patients evaluated within 4.5 h. Although absence of ILVO was associated with slightly better prognosis, more than half had a poor outcome at 3 months.
Filiaciones:
Giralt-Steinhauer, E:
Hosp Mar, Dept Neurol, Neurovasc Res Grp, Barcelona, Spain
Ois, A:
Hosp Mar, Dept Neurol, Neurovasc Res Grp, Barcelona, Spain
Abilleira, S:
CAHIAQ, Stroke Programme, Barcelona, Spain
Urra, X:
Hosp Clin Barcelona, Barcelona, Spain
Cardona-Portela, P:
Hosp Univ Bellvitge, Barcelona, Spain
Gomis, M:
Hosp GermansTrias & Pujol Badalona, Badalona, Spain
Castellanos, M:
Hosp Univ JosepTrueta Girona, Girona, Spain
Molina, C:
Hosp Univ ValldHebron, Barcelona, Spain
Marti-Fabregas, J:
Hosp Univ Santa Creu & St Pau, Barcelona, Spain
Pellise, A:
Hosp Univ Joan XXIII Tarragona, Tarragona, Spain
Canovas, D:
Hosp Parc Tauli Sabadell, Barcelona, Spain
Gomez-Choco, M:
Hosp Moises Broggi, Barcelona, Spain
Kuprinski, J:
Hosp Univ Mutua Terrassa, Barcelona, Spain
MMU, Healthcare Sci, Manchester, Lancs, England
Cocho, D:
Hosp Granollers, Granollers, Spain
Roquer, J:
Hosp Mar, Dept Neurol, Neurovasc Res Grp, Barcelona, Spain
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