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Endovascular stroke treatment after 6‐24 hours only needs non‐contrast CT
Author(s) -
Delgado Acosta Fernando,
Jiménez Gómez Elvira,
Bravo Rey Isabel,
Bolivar Aurora,
Valverde Moyano Roberto,
Oteros Fernández Rafael
Publication year - 2021
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13348
Subject(s) - medicine , neuroradiology , endovascular treatment , stroke (engine) , interventional neuroradiology , demographics , occlusion , inclusion and exclusion criteria , radiology , perfusion scanning , neuroimaging , confidence interval , perfusion , neurology , surgery , aneurysm , mechanical engineering , demography , alternative medicine , pathology , psychiatry , sociology , engineering
Objectives Imaging selected patients with proximal anterior circulation stroke who demonstrate limited infarct may benefit from endovascular treatment beyond conventional time limits. Our aim was to evaluate the results of the EVT group series arriving between 6 and 24 hours from the onset of symptoms with (ASPECTS) ≥7 to our hospital (with 24/7 interventional neuroradiology) comparing them with those obtained in our prospectively registered series arriving between 0 and 6 hours. Materials and methods The inclusion criteria were ≥18 years, an interval between stroke and endovascular treatment of 6‐24 hours, prestroke score mRS 0‐2, no intracranial haemorrhage, (NIHSS) scale 8‐22 and infarct evaluated by CT scan ≥7 in ASPECTS scale. Data, including patient demographics, neuroimaging findings, procedural details, recanalization rates and 90‐day mRS, were collected. Results Twelve of the 14 (85.71%) endovascular group patients who came to our centre between 6 and 24 hours had good outcomes at 90 days. To confirm our findings, we evaluated patients treated at our centre who met the selection criteria from January 2017 to September 2019. In this period, 382 patients with large vessel occlusion were treated endovascularly. 56 patients met all the criteria for inclusion and exclusion for our study. 31 of these 56 patients (56.36%) obtained a (mRS) scale ≤2 at three months. There was no significant difference ( P = 0.063). Conclusion In circumstances of difficult access to MRI or CT perfusion, a computed tomography of ASPECTS ≥7 is sufficient to indicate endovascular treatment in a stroke of known onset between 6 and 24 hours.