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CardioVascular and Interventional Radiology

, Volume 36, Issue 5, pp 1241–1246 | Cite as

Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

  • Lars Fjetland
  • Sumit Roy
  • Kathinka D. Kurz
  • Tore Solbakken
  • Jan Petter Larsen
  • Martin W. Kurz
Clinical Investigation

Abstract

Purpose

Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT.

Methods

Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy.

Results

Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome.

Conclusions

Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged ≥80 years.

Keywords

Neurointerventions Endovascular treatment Stroke therapy Thrombectomy Thrombolysis Brain/neurological/nervous system Stroke 

Notes

Conflict of interest

Martin W. Kurz has received payment for lectures from Bayer Health Care and Boehringer Ingelheim. Jan Petter Larsen has received payment for lectures from Lundbeck Pharma and is a board member of the same company. The other authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2013

Authors and Affiliations

  • Lars Fjetland
    • 1
    • 2
  • Sumit Roy
    • 1
  • Kathinka D. Kurz
    • 1
  • Tore Solbakken
    • 3
  • Jan Petter Larsen
    • 2
    • 3
  • Martin W. Kurz
    • 2
    • 3
  1. 1.Department of RadiologyStavanger University HospitalStavangerNorway
  2. 2.The Norwegian Center for Movement Disorders, Stavanger University HospitalStavangerNorway
  3. 3.Department of NeurologyStavanger University HospitalStavangerNorway

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