Prognostic factors for neurologic outcome after endovascular revascularization of acute symptomatic occlusion of the internal carotid artery

Dae Chu Suh, J. K. Kim, C. G. Choi, S. J. Kim, H. W. Pyun, C. Ahn, D. H. Yang, K. S. Lim, J. G. Leem, K. D. Hahm, J. H. Lee, S. U. Kwon, J. S. Kim

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Abstract

BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion. MATERIALS AND METHODS: We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes. RESULTS: Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42%) of 33 and good recovery (mRS ≤2) after 1 year in 11 (33%) of 33. Distal residual occlusion (DRO; P = .005), initial NIHSS score (P = .023), and postprocedural thrombolysis in cerebral infarction (P = .027), retrograde ICA filling (P = .036), and ophthalmic collaterals (P = .046) were significant predictors of short-term outcome. DRO (P = .018) and initial NIHSS (P = .033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term (P = .026) and long-term outcome (P = .033) on multivariable logistic regression. CONCLUSIONS: Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.

Original languageEnglish (US)
Pages (from-to)1167-1171
Number of pages5
JournalAmerican Journal of Neuroradiology
Volume28
Issue number6
DOIs
StatePublished - Jun 2007

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Internal Carotid Artery
Nervous System
National Institutes of Health (U.S.)
Stroke
Cerebral Infarction
Logistic Models

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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Prognostic factors for neurologic outcome after endovascular revascularization of acute symptomatic occlusion of the internal carotid artery. / Suh, Dae Chu; Kim, J. K.; Choi, C. G.; Kim, S. J.; Pyun, H. W.; Ahn, C.; Yang, D. H.; Lim, K. S.; Leem, J. G.; Hahm, K. D.; Lee, J. H.; Kwon, S. U.; Kim, J. S.

In: American Journal of Neuroradiology, Vol. 28, No. 6, 06.2007, p. 1167-1171.

Research output: Contribution to journalArticle

Suh, DC, Kim, JK, Choi, CG, Kim, SJ, Pyun, HW, Ahn, C, Yang, DH, Lim, KS, Leem, JG, Hahm, KD, Lee, JH, Kwon, SU & Kim, JS 2007, 'Prognostic factors for neurologic outcome after endovascular revascularization of acute symptomatic occlusion of the internal carotid artery', American Journal of Neuroradiology, vol. 28, no. 6, pp. 1167-1171. https://doi.org/10.3174/ajnr.A0492
Suh, Dae Chu ; Kim, J. K. ; Choi, C. G. ; Kim, S. J. ; Pyun, H. W. ; Ahn, C. ; Yang, D. H. ; Lim, K. S. ; Leem, J. G. ; Hahm, K. D. ; Lee, J. H. ; Kwon, S. U. ; Kim, J. S. / Prognostic factors for neurologic outcome after endovascular revascularization of acute symptomatic occlusion of the internal carotid artery. In: American Journal of Neuroradiology. 2007 ; Vol. 28, No. 6. pp. 1167-1171.
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abstract = "BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion. MATERIALS AND METHODS: We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes. RESULTS: Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42{\%}) of 33 and good recovery (mRS ≤2) after 1 year in 11 (33{\%}) of 33. Distal residual occlusion (DRO; P = .005), initial NIHSS score (P = .023), and postprocedural thrombolysis in cerebral infarction (P = .027), retrograde ICA filling (P = .036), and ophthalmic collaterals (P = .046) were significant predictors of short-term outcome. DRO (P = .018) and initial NIHSS (P = .033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term (P = .026) and long-term outcome (P = .033) on multivariable logistic regression. CONCLUSIONS: Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.",
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T1 - Prognostic factors for neurologic outcome after endovascular revascularization of acute symptomatic occlusion of the internal carotid artery

AU - Suh, Dae Chu

AU - Kim, J. K.

AU - Choi, C. G.

AU - Kim, S. J.

AU - Pyun, H. W.

AU - Ahn, C.

AU - Yang, D. H.

AU - Lim, K. S.

AU - Leem, J. G.

AU - Hahm, K. D.

AU - Lee, J. H.

AU - Kwon, S. U.

AU - Kim, J. S.

PY - 2007/6

Y1 - 2007/6

N2 - BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion. MATERIALS AND METHODS: We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes. RESULTS: Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42%) of 33 and good recovery (mRS ≤2) after 1 year in 11 (33%) of 33. Distal residual occlusion (DRO; P = .005), initial NIHSS score (P = .023), and postprocedural thrombolysis in cerebral infarction (P = .027), retrograde ICA filling (P = .036), and ophthalmic collaterals (P = .046) were significant predictors of short-term outcome. DRO (P = .018) and initial NIHSS (P = .033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term (P = .026) and long-term outcome (P = .033) on multivariable logistic regression. CONCLUSIONS: Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.

AB - BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion. MATERIALS AND METHODS: We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes. RESULTS: Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42%) of 33 and good recovery (mRS ≤2) after 1 year in 11 (33%) of 33. Distal residual occlusion (DRO; P = .005), initial NIHSS score (P = .023), and postprocedural thrombolysis in cerebral infarction (P = .027), retrograde ICA filling (P = .036), and ophthalmic collaterals (P = .046) were significant predictors of short-term outcome. DRO (P = .018) and initial NIHSS (P = .033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term (P = .026) and long-term outcome (P = .033) on multivariable logistic regression. CONCLUSIONS: Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.

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