| Occurrence and predictors of futile recanalization following endovascular treatment among patients with acute ischemic stroke: a multicenter study. | |
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MedLine Citation:
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PMID: 20075087 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Although recanalization is the goal of thrombolysis, it is well recognized that it fails to improve outcome of acute stroke in a subset of patients. Our aim was to assess the rate of and factors associated with "futile recanalization," defined by absence of clinical benefit from recanalization, following endovascular treatment of acute ischemic stroke. MATERIALS AND METHODS: Data from 6 studies of acute ischemic stroke treated with mechanical and/or pharmacologic endovascular treatment were analyzed. "Futile recanalization" was defined by the occurrence of unfavorable outcome (mRS score of > or = 3 at 1-3 months) despite complete angiographic recanalization (Qureshi grade 0 or TIMI grade 3). RESULTS: Complete recanalization was observed in 96 of 270 patients treated with IA thrombolysis. Futile recanalization was observed in 47 (49%). In univariate analysis, patients with futile recanalization were older (73 +/- 11 versus 58 +/- 15 years, P < .0001) and had higher median initial NIHSS scores (19 versus 14, P < .0001), more frequent BA occlusion (17% versus 4%, P = .049), less frequent MCA occlusion (53% versus 76%, P = .032), and a nonsignificantly higher rate of symptomatic hemorrhagic complications (2% versus 9%, P = .2). In logistic regression analysis, futile recanalization was positively associated with age > 70 years (OR, 4.4; 95% CI, 1.9-10.5; P = .0008) and initial NIHSS score 10-19 (OR, 3.8; 95% CI, 1.7-8.4; P = .001), and initial NIHSS score > or = 20 (OR, 64.4; 95% CI, 28.8-144; P < .0001). CONCLUSIONS: Futile recanalization is a relatively common occurrence following endovascular treatment, particularly among elderly patients and those with severe neurologic deficits. |
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Authors:
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H M Hussein; A L Georgiadis; G Vazquez; J T Miley; M Z Memon; Y M Mohammad; G A Christoforidis; N Tariq; A I Qureshi |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2010-01-14 |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 31 ISSN: 1936-959X ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-16 Completed Date: 2010-06-10 Revised Date: 2011-12-20 |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: United States |
Other Details:
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Languages: eng Pagination: 454-8 Citation Subset: IM |
Affiliation:
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Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota, USA. husseihm@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Age Distribution Aged Brain Ischemia / drug therapy*, epidemiology*, radiography Cerebral Revascularization / statistics & numerical data, utilization* Clinical Trials as Topic / statistics & numerical data Female Humans Male Medical Futility Middle Aged Multivariate Analysis Predictive Value of Tests Retreatment Risk Factors Stroke / drug therapy*, epidemiology*, radiography Thrombolytic Therapy / statistics & numerical data, utilization* Treatment Failure |
| Comments/Corrections | |
Comment In:
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AJNR Am J Neuroradiol. 2011 Nov;32(10):1769-70
[PMID:
21940806
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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