Small vessel disease and clinical outcomes after endovascular treatment in acute ischemic stroke

  • Francesco ArbaEmail author
  • Giuseppe Dario Testa
  • Nicola Limbucci
  • Sergio Nappini
  • Leonardo Renieri
  • Giovanni Pracucci
  • Patrizia Nencini
  • Domenico Inzitari
Original Article



Pre-existing small vessel disease (SVD) has been associated with poor functional outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis; however, there are scarce data in patients treated with endovascular therapy. We aimed to investigate the associations between SVD and clinical outcomes in patients treated with endovascular therapy.


We retrospectivel y evaluated patients with acute ischemic stroke in the anterior circulation receiving endovascular treatment. We assessed SVD markers with visual scales using non-contrast computed tomography. Early outcomes included intracerebral hemorrhage and 7-day/discharge stroke severity, and late outcomes included modified Rankin scale (mRS) 90 days after stroke. We used logistic and ordinal regression models adjusted for age, sex, stroke severity, and time-to-groin puncture time.


A total of 175 patients were included in the study, mean (±SD) age 72.3 (± 12.4) years, 90 (51%) males. Among SVD features, only brain atrophy was associated with 7-day stroke severity (OR = 2.28; 95% CI = 1.11–4.68) and with worse mRS at 90 days (OR = 2.72; 95% CI = 1.25–5.91). Global SVD burden was associated with worse mRS at 90 days (OR = 1.63; 95% CI = 1.01–2.62) but not with 7-day stroke severity (OR = 1.71; 95% CI = 0.97–3.01).


Pre-existing SVD burden, mainly driven by brain atrophy, negatively affects early and late clinical outcomes in anterior circulation ischemic stroke treated with endovascular therapy. Our results may help prognostic stratification of stroke patients treated with endovascular therapy.


Small vessel disease CT Endovascular treatment Acute stroke Clinical outcomes 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Geriatric DepartmentCareggi University HospitalFlorenceItaly
  2. 2.NEUROFARBA DepartmentUniversity of FlorenceFlorenceItaly
  3. 3.Neurovascular Interventional UnitCareggi University HospitalFlorenceItaly

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