Literature DB >> 31280021

Association between initial NIHSS score and recanalization rate after endovascular thrombectomy.

Junya Aoki1, Kentaro Suzuki2, Takuya Kanamaru2, Akihito Kutsuna2, Takehiro Katano2, Yohei Takayama2, Yuji Nishi2, Yuho Takeshi2, Toru Nakagami2, Shinichiro Numao2, Arata Abe2, Satoshi Suda2, Yasuhiro Nishiyama2, Kazumi Kimura2.   

Abstract

BACKGROUND: National institutes of Health Stroke Scale (NIHSS) score and the presence of successful recanalization are crucial determinants of clinical outcome in patients with major artery occlusion. However, it is unknown whether successful recanalization rate after endovascular therapy (EVT) depends on NIHSS score.
METHODS: From our prospective EVT registry, data on patients with an occlusion at the internal carotid artery or middle cerebral artery were analyzed. Successful recanalization was judged as positive when reperfusion of the thrombolysis in cerebral infarction (TICI) scale ≥2b was observed. Successful recanalization rate was also evaluated based on the NIHSS score subgroups: 0-8, 9-16, 17-24, and >24. Multivariate regression analysis was used to evaluate the impact of NIHSS score on successful recanalization.
RESULTS: We studied 183 patients (age 76 [68-83], male 110 [60%], NIHSS score 19 [14-24]). One hundred and forty-six (80%) patients had the successful recanalization. Patients achieved the recanalization had lower NIHSS score as 18 (12-23), contrary those failed it had higher NIHSS score as 24 (20-27) (p < .001). Successful recanalization rate was correlated to the NIHSS score grade; 100% in the NIHSS 0-8 group, 88% in 9-16, 81% in 17-24, and only 60% in >24 (p < .001). Multivariate regression analysis showed NIHSS score was an independent parameter of recanalization (odds ratio 0.905 [95%CI 0.837-0.979], p = .013).
CONCLUSION: NIHSS score may serve as a predictor of successful recanalization. Recanalization is relatively easier in mild stroke than in those with severe stroke.
Copyright © 2019 Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Anterior circulation occlusion; Ischemic stroke; Recanalization; Thrombectomy

Year:  2019        PMID: 31280021     DOI: 10.1016/j.jns.2019.06.033

Source DB:  PubMed          Journal:  J Neurol Sci        ISSN: 0022-510X            Impact factor:   3.181


  5 in total

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