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Survival and functional outcome following endovascular thrombectomy for anterior circulation acute ischemic stroke caused by large vessel occlusion in Sweden 2017–2019: a nationwide, prospective, observational study
Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Neurology, Skåne University Hospital Lund/Malmö, Lund, Sweden.
School of Medicine, Örebro University, Örebro, Sweden.
Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Neuroradiology, Skåne University Hospital, Lund, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Department of Clinical Science, Karolinska Institute Danderyds hospital, Stockholm, Sweden.ORCID-id: 0000-0001-8522-1707
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2023 (Engelska)Ingår i: Interventional Neuroradiology, ISSN 1591-0199, E-ISSN 2385-2011, Vol. 29, nr 1, s. 94-101Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Endovascular thrombectomy (EVT) is standard of care for anterior circulation acute ischemic stroke (AIS) caused by large vessel occlusion (LVO), but data on nationwide performance in routine healthcare are sparse. The study aims were to describe EVT patients with LVO AIS, analyze mortality and functional outcome, and compare results with randomized controlled trials (RCTs).

Methods: Data from the Riksstroke and the Swedish Endovascular Treatment of Acute Stroke Registry (RSEVAS) on pre-stroke independent patients, with LVO AIS in 2017–2019, defined as occlusion of the intracranial internal carotid artery, or the M1 or M2 segments of the middle cerebral artery, and groin puncture <6 h of onset, were compared to aggregated HERMES collaboration RCT data. We assessed 90-day survival and function, defined by the modified Rankin Scale. Specific analyzes were stratified by occlusion location.

Results: In all, 1011/2560 of RSEVAS patients matched RCT inclusion criteria. Compared with RCT data, patients were older (73 vs. 68), fewer received intravenous thrombolysis (63.1% vs. 83%), and M2 occlusions were more common (24.5% vs. 8%). 90-day survival in RSEVAS was 85.3%, 42.8% achieved good outcome and 5% had symptomatic intracerebral hemorrhage (sICH). Corresponding outcomes in RCT data were 84.7% survival, 46% good outcome, and 4.4% sICH. Functional outcome was most favorable following M2 occlusions.

Conclusions: EVT patients from our large real-world national dataset differed from RCT patients in several baseline factors including distribution of vascular occlusion site. However, the overall outcome of EVT in our Swedish cohort appeared to well match the pivotal trial findings.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2023. Vol. 29, nr 1, s. 94-101
Nyckelord [en]
acute stroke therapy, functional outcome, ischemic stroke, registry, Reperfusion, survival
Nationell ämneskategori
Neurologi Kardiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-192078DOI: 10.1177/15910199211073019ISI: 000748884800001PubMedID: 35044270Scopus ID: 2-s2.0-85147047447OAI: oai:DiVA.org:umu-192078DiVA, id: diva2:1634457
Tillgänglig från: 2022-02-02 Skapad: 2022-02-02 Senast uppdaterad: 2023-10-25Bibliografiskt granskad

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