Benefit of endovascular treatment for primary versus secondary medium vessel occlusion: A multi‐center experience

• Published in: CNS neuroscience & therapeutics Vol. 30; no. 3; pp. e14687 - n/a
• Main Authors: Hu, Hai‐Zhou, Zhao, Yong‐Gang, Liu, Xin, Sun, Xian‐Hui, Nguyen, Thanh N., Chen, Hui‐Sheng
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-03-2024; John Wiley and Sons Inc
• Subjects: Blood clots; Cardiovascular system; Carotid arteries; Cerebral blood flow; Cerebral infarction; endovascular treatment; Generalized linear models; intracranial hemorrhage; Ischemia; ischemic stroke; Medical imaging; medium vessel occlusion; Mortality; Observational studies; Original; outcome; Patient safety; Patients; Performance evaluation; Regression analysis; Stroke; Thrombolysis; Veins & arteries; China; medium vessel occlusion; intracranial hemorrhage; endovascular treatment; ischemic stroke; outcome
• ISSN: 1755-5930; 1755-5949; 1755-5949
• DOI: 10.1111/cns.14687

Aims
This study aimed to compare the clinical outcomes and safety of endovascular treatment (EVT) in patients with primary versus secondary medium vessel occlusion (MeVO).
Methods
From the endovascular treatment for acute ischemic stroke in the China registry, we collected consecutive patients with MeVO who received EVT. The primary endpoint was a good outcome, defined as a modified Rankin Scale (mRS) 0 to 2 at 90 days.
Results
154 patients were enrolled in the final analysis, including 74 primary MeVO and 80 secondary MeVO. A good outcome at 90 days was achieved in 42 (56.8%) patients with primary MeVO and 33 (41.3%) patients with secondary MeVO. There was a higher probability of good outcomes in patients with the primary vs secondary MeVO (adjusted odds ratio, 2.16; 95% confidence interval, 1.04 to 4.46; p = 0.04). There were no significant differences in secondary and safety outcomes between MeVO groups. In the multivariable analysis, baseline ASPECTS (p = 0.001), final modified thrombolysis in cerebral infarction score (p = 0.01), and any ICH (p = 0.03) were significantly associated with good outcomes in primary MeVO patients, while baseline National Institutes of Health Stroke Scale (p = 0.002), groin puncture to recanalization time (p = 0.02), and early neurological improvement (p < 0.001) were factors associated with good outcome in secondary MeVO patients.
Conclusion
In MeVO patients who received EVT, there was a higher likelihood of poor outcomes in patients with secondary versus primary MeVO.
This study aimed to compare the clinical outcomes and safety of endovascular treatment (EVT) in patients with primary versus secondary medium vessel occlusion (MeVO). In MeVO patients who received EVT, there was higher likelihood of poor outcome in patients with secondary versus primary MeVO.