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Leaving the day behind: endovascular therapy beyond 24 h in acute stroke of the anterior and posterior circulation

Background:There is little evidence of endovascular therapy (EVT) being performed in acute ischemic stroke beyond 24 h, and that evidence is limited to anterior circulation stroke.Objective:To extend evidence of efficacy and safety of EVT after more than 24?h in both anterior and posterior circulati...

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Main Authors: Purrucker, Jan (Author) , Ringleb, Peter A. (Author) , Seker, Fatih (Author) , Potreck, Arne (Author) , Nagel, Simon (Author) , Schönenberger, Silvia (Author) , Berberich, Anne (Author) , Neuberger, Ulf (Author) , Möhlenbruch, Markus Alfred (Author) , Weyland, Charlotte S. (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: Therapeutic advances in neurological disorders
Year: 2022, Volume: 15, Pages: 1-11
ISSN:1756-2864
DOI:10.1177/17562864221101083
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/17562864221101083
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/17562864221101083
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Author Notes:Jan C. Purrucker, Peter A. Ringleb, Fatih Seker, Arne Potreck, Simon Nagel, Silvia Schönenberger, Anne Berberich, Ulf Neuberger, Markus Möhlenbruch and Charlotte Weyland
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Summary:Background:There is little evidence of endovascular therapy (EVT) being performed in acute ischemic stroke beyond 24 h, and that evidence is limited to anterior circulation stroke.Objective:To extend evidence of efficacy and safety of EVT after more than 24?h in both anterior and posterior circulation stroke.Methods:Local, prospectively collected registries were screened for patients with acute ischemic stroke and large-vessel occlusion who had received either EVT?>?24?h after last-seen-well but <24?h after symptom recognition (EVT>24LSW) or EVT?>?24?h since first (definitive) symptom recognition (EVT>24DEF). Patients treated <24?h served as a group for comparison. Favorable outcome was defined as modified Rankin scale (mRS) 0?2 or return to prestroke mRS at 3?months.Results:Between January 2014 and August 2021, N?=?2347 were treated with EVT at our comprehensive stroke center, of whom n?=?43 met the inclusion criteria (EVT>24LSW, n?=?16, EVT>24DEF, n?=?27). EVT>24LSW patients were treated at a median of 28.7?h [interquartile range (IQR)?=?27.3?32.8] after last-seen-well and 7.3?h (IQR?=?2.8?14.3) after symptom recognition; EVT>24DEF patients were treated 52.5?h (IQR?=?26.5?94.2) after first symptoms. Favorable outcome was achieved by 23.3% (10/43) in the EVT?>?24 compared with 39.4% (886/2250) in the EVT??24, 27.9% (12/43) versus EVT??24, 41.7% (5/12) versus EVT?
Item Description:Gesehen am 03.06.2022
Physical Description:Online Resource
ISSN:1756-2864
DOI:10.1177/17562864221101083

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