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Endovascular treatment over 24 hours after ischemic stroke onset: a single-center retrospective study

  • Interventional Neuroradiology
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Abstract

Purpose

The aim of this study is to evaluate the safety and effectiveness of endovascular treatment (EVT) for acute ischemic stroke caused by large-vessel obstruction or stenosis (AIS-LVO/S) over 24 h after first AIS symptom recognition (FAISSR).

Methods

A total of 33 AIS-LVO/S cases with EVT over 24 h after FAISSR during the period from January 2019 to February 2022 in our hospital were divided into the 90d mRS ≤ 2 group [favorable outcome (FO) group] and 90d mRS > 2 group [unfavorable outcome (UFO) group] and retrospectively analyzed.

Results

The reperfusion was successfully established with EVT in 97% (32/33) of cases, and most (63.6%, 21/33) had 90d mRS ≤ 2 and only 36.4% (12/33) had 90d mRS > 2. Preoperative DWI-ASPECT and ASITN/SIR scores were significantly higher and NIHSS scores were significantly lower in the FO group than those in the UFO group (P < 0.05). In addition, the FAISSR to exacerbation time, FAISSR to groin puncture time, and FAISSR to reperfusion time were significantly longer, and the groin puncture to reperfusion time was significantly shorter in the FO group than those in the UFO group (P < 0.05), but there was no significant difference in the stroke exacerbation to groin puncture time (P > 0.05). The patients with cerebral infarction due to artery dissection had more favorable EVT outcomes, but the patients with posterior cerebral circulation infarction had very poor EVT outcomes.

Conclusions

The FAISSR to groin puncture time over 24 h may not be a taboo for EVT and it may be safe and effective for AIS-LVO/S in anterior cerebral circulation, especially with lower preoperative NIHSS scores.

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Data availability

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Acknowledgements

The authors are grateful to all of the patients and/or their next of kin for their consent to publication of this study and accompanying images.

Funding

This study was supported by Jiangxi Provincial People’s Hospital Grant 2019–009.

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Authors and Affiliations

  1. Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, 92 Aiguo Road, Nanchang, 330006, Jiangxi, People’s Republic of China

    Shimin Liu, Wenfeng Cao, Lingfeng Wu, An Wen, Yongliang Zhou, Zhengbing Xiang, Wei Rao & Dongyuan Yao

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  1. Shimin Liu
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Correspondence to Dongyuan Yao.

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The authors declare no conflict of interest in relation to this study.

Ethics approval

All procedures and research protocols were approved by the Research Ethics Committee of Jiangxi Provincial People’s Hospital (No. 2022–035).

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Informed consent was obtained from all the patients and/or their next of kin for publication of this study and accompanying images.

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Liu, S., Cao, W., Wu, L. et al. Endovascular treatment over 24 hours after ischemic stroke onset: a single-center retrospective study. Neuroradiology 65, 793–804 (2023). https://doi.org/10.1007/s00234-022-03105-6

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