Clinical effect of successful reperfusion in patients presenting with NIHSS < 8: data from the BEYOND-SWIFT registry.

Détails

ID Serval
serval:BIB_B18BC2D88418
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical effect of successful reperfusion in patients presenting with NIHSS < 8: data from the BEYOND-SWIFT registry.
Périodique
Journal of neurology
Auteur(s)
Kaesmacher J., Chaloulos-Iakovidis P., Panos L., Mordasini P., Heldner M.R., Kurmann C.C., Michel P., Hajdu S.D., Ribo M., Requena M., Maegerlein C., Friedrich B., Costalat V., Benali A., Pierot L., Gawlitza M., Schaafsma J., Pereira V.M., Gralla J., Fischer U.
ISSN
1432-1459 (Electronic)
ISSN-L
0340-5354
Statut éditorial
Publié
Date de publication
03/2019
Peer-reviewed
Oui
Volume
266
Numéro
3
Pages
598-608
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
If patients presenting with large vessel occlusions (LVO) and mild symptoms should be treated with endvoascular treatment (EVT) remains unclear. Aims of this study were (1) assessing the safety and technical efficacy of EVT in patients with NIHSS < 8 as opposed to a comparison group of patients presenting with NIHSS ≥ 8 and (2) evaluation of the clinical effect of reperfusion in patients with NIHSS < 8.
Patients included into the retrospective multicenter BEYOND-SWIFT registry (NCT03496064) were analyzed. Clinical effect of achieving successful reperfusion (defined as modified Thrombolysis in Cerebral Infarction grade 2b/3) in patients presenting with NIHSS < 8 (N = 193) was evaluated using multivariable logistic regression analyses (displayed as adjusted Odds Ratios, aOR and 95% confidence intervals, 95%-CI). Primary outcome was excellent functional outcome (modified Rankin Scale, mRS 0-1) at day 90. Safety and efficacy of mechanical thrombectomy in patients with NIHSS < 8 was compared to patients presenting with NIHSS ≥ 8 (N = 1423).
Among patients with NIHSS < 8 (N = 193, 77/193, 39.9% receiving pre-interventional IV-tPA), successful reperfusion was significantly related to mRS 0-1 (aOR 3.217, 95%-CI 1.174-8.816) and reduced the chances of non-hemorrhagic neurological worsening (aOR 0.194, 95%-CI 0.050-0.756) after adjusting for prespecified confounders. In interaction analyses, the relative merits of achieving successful reperfusion were mostly comparable between patients presenting with NIHSS < 8 and NIHSS ≥ 8 as evidenced by non-significantly different aOR. Interventional safety and efficacy metrics were similar between patients with NIHSS < 8 and NIHSS ≥ 8.
Achieving successful reperfusion is beneficial in patients with persisting LVO presenting with NIHSS < 8 and reduces the risk of non-hemorrhagic neurological worsening.
Mots-clé
Aged, Aged, 80 and over, Female, Fibrinolytic Agents/therapeutic use, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Mechanical Thrombolysis/methods, Middle Aged, Outcome Assessment (Health Care), Registries, Reperfusion/methods, Retrospective Studies, Severity of Illness Index, Stroke/diagnosis, Stroke/diagnostic imaging, Stroke/therapy, Endovascular, Low NIHSS, Mechanical thrombectomy, Mild symptoms, Stroke, Thrombolysis
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/02/2019 16:20
Dernière modification de la notice
20/08/2019 16:20
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