ArticleInternational journal of stroke : official journal of the International Stroke Society2024
Baseline clinical and neuroradiological predictors of outcome in patients with large ischemic core undergoing mechanical thrombectomy: A retrospective multicenter study.
Article in International journal of stroke : official journal of the International Stroke Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Current Advancement and Patient Outcomes in Reperfusion Brain Injuries After Stroke: A Comparative Analysis of Thrombolysis and Thrombectomy.Brain and behavior · 2025Pooled it
- Factors associated with symptom relief and lesion formation in acute ischemic stroke and transient ischemic attack.BMC neurology · 2026Article
- The inflammation-fibrosis combined index as a predictor of prognosis in stroke patients undergoing mechanical thrombectomy.Frontiers in aging neuroscience · 2026Article
- Sex Differences in Prognostic Markers: Exploring Outcome Variability After Mechanical Thrombectomy in Large Vessel Occlusion Stroke.Journal of clinical medicine · 2025Article
- Intravenous Thrombolysis in Acute Ischemic Stroke: A Prognostic Prediction Model and the Role of Ischemic Core Growth Rate.CNS neuroscience & therapeutics · 2025Article
- Dual-Energy CT-Based Assessment of Thrombotic Heterogeneity for Predicting Stroke Source and Response to Machine Thrombectomy: A Step Toward Visualization Thrombus Treatment.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Observational
- Mechanical thrombectomy failure in anterior and posterior circulation stroke: current results from a high-volume comprehensive center.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- The Roles of Heart Rate Variability in Cerebral Stroke.Neuropsychiatric disease and treatment · 2025Review
- Venous outflow time profiles: promising imaging biomarkers for futile recanalization in acute ischemic stroke due to large vessel occlusion.Frontiers in neurology · 2025Article
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Authors and funding
47 authors at 19 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent randomized trials have shown the benefit of mechanical thrombectomy (MT) also in patients with an established large ischemic core.
aimsThe purpose of this study was to define baseline predictors of clinical outcome in patients with large vessel occlusion (LVO) in the anterior circulation and an Alberta Stroke Program Early CT score (ASPECTS) ⩽ 5, undergoing MT. MATERIAL AND
methodsThe databases of 16 comprehensive stroke centers were retrospectively screened for patients with LVO and ASPECTS ⩽5 that received MT. Baseline clinical and neuroradiological features, including the differential contribution of all ASPECTS regions to the composite score, were collected. Primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0-2. Statistical analysis used a logistic regression model and random forest algorithm.
resultsA total of 408 patients were available for analysis. In multivariate model, among baseline features, lower age (odd ratio (OR) = 0.962, 95% confidence interval (CI) = 0.943-0.982) and lower National Institute of Health Stroke Scale (NIHSS) score (OR = 0.911, 95% CI = 0.862-0.963) were associated with the mRS score 0-2. Involvement of the M2 (OR = 0.398, 95% CI = 0.206-0.770) or M4 (OR = 0.496, 95% CI = 0.260-0.945) ASPECTS regions was associated with an unfavorable outcome. Random forest analysis confirmed that age and baseline NIHSS score are the most important variables influencing clinical outcome, whereas involvement of cortical regions M5, M4, M2, and M1 can have a negative impact.
conclusionOur retrospective analysis shows that, along with age and baseline clinical impairment, presence of early ischemic changes involving cortical areas has a role in clinical outcome in patients with large ischemic core undergoing MT. DATA ACCESS STATEMENT: The data that support the findings of this study are available upon reasonable request.
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