Outcome after Thrombectomy of Acute M1 and Carotid-T Occlusions with Involvement of the Corticospinal Tract in Postinterventional Imaging

  • Objectives: Until now, thrombectomy studies have provided little reliable information about the correlation between the infarct topography and clinical outcome of acute stroke patients with embolic large-vessel occlusions. Therefore, we aimed to analyze whether infarcts of the corticospinal tracts in the central white matter (CWM) or the internal capsule on postinterventional imaging controls are associated with poor clinical outcome after thrombectomy. Materials and Methods: We retrospectively analyzed imaging data from 70 patients who underwent endovascular thrombectomy for emergent middle cerebral artery or carotid-T occlusions. Inclusion criteria were postinterventional infarct demarcation in the regions of the internal capsule, caudate, lentiform nucleus, and CWM. Primary outcome was the mRS after 90 days and secondary endpoints were subgroup analyses regarding additional cortical infarction. Conclusions: In this exploratory study, we found no indication that infarcts in the course of the corticospinal tracts predict poor clinical outcome after successful thrombectomy in patients with embolic carotid-T or M1 occlusions. In our analysis, a significant number of patients showed a favorable 90 day outcome. Additional cortical infarcts may have a greater impact on the risk of an unfavorable outcome. Results: Good clinical outcome after 90 days (mRS 0–2) was shown in 36 out of 70 patients (51.4%), with excellent clinical outcome (mRS 0–1) in 23 patients (32.9%). Here, 58.6% patients lived at home without nursing service after 90 days. Patients with minimal additional cortical infarction in postinterventional imaging had a 75.6% better chance of excellent outcome.

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Author:Sarah ReitzORCiDGND, Ellen Gerhard, Stella Breuer, Ferdinand BohmannORCiDGND, Waltraud PfeilschifterORCiDGND, Joachim BerkefeldORCiDGND
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
Date of Publication (online):2022/05/17
Date of first Publication:2022/05/17
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/12/06
Tag:acute stroke; cerebrovascular disease; corticospinal tracts; endovascular recanalization; endovascular treatment
Issue:10, art. 2823
Article Number:2823
Page Number:11
First Page:1
Last Page:11
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International