TY - JOUR
TI - Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real-world multicenter experience
AU - Yeo, L.L.-L.
AU - Chen, V.H.E.
AU - Leow, A.S.-T.
AU - Meyer, L.
AU - Fiehler, J.
AU - Tu, T.-M.
AU - Tham, C.H.
AU - Sia, C.-H.
AU - Jamous, A.
AU - Behme, D.
AU - Kastrup, A.
AU - Papanagiotou, P.
AU - Styczen, H.
AU - Forsting, M.
AU - Lee, T.-H.
AU - Chu, C.-L.
AU - Fischer, S.
AU - Maus, V.
AU - Abdullayev, N.
AU - Kabbasch, C.
AU - Mönch, S.
AU - Maegerlein, C.
AU - Arnberg, F.
AU - Andersson, T.
AU - Holmin, S.
AU - Teoh, H.-L.
AU - Paliwal, P.
AU - Ahmad, A.
AU - Gopinathan, A.
AU - Yang, C.
AU - Seet, R.C.-S.
AU - Chan, B.P.-L.
AU - Sharma, V.K.
AU - Tan, B.Y.-Q.
JO - European Journal of Paediatric Neurology
PY - 2021
VL - 28
TODO - 8
SP - 2736-2744
PB - John Wiley and Sons Inc
SN - 1090-3798
TODO - 10.1111/ene.14899
TODO - acute ischemic stroke;  adult;  artery dissection;  Article;  basilar artery;  blood clot lysis;  clinical effectiveness;  cohort analysis;  controlled study;  female;  Germany;  health care quality;  human;  hypertension;  in-hospital mortality;  internal carotid artery;  major clinical study;  male;  middle cerebral artery;  National Institutes of Health Stroke Scale;  occlusive cerebrovascular disease;  outcome assessment;  percutaneous thrombectomy;  posterior cerebral artery;  Rankin scale;  risk factor;  Singapore;  Sweden;  Taiwan;  vertebral artery;  brain ischemia;  cerebrovascular accident;  clinical trial;  complication;  endovascular surgery;  multicenter study;  retrospective study;  thrombectomy;  treatment outcome;  young adult, Brain Ischemia;  Cohort Studies;  Endovascular Procedures;  Humans;  Ischemic Stroke;  Retrospective Studies;  Stroke;  Thrombectomy;  Treatment Outcome;  Young Adult
TODO - Endovascular thrombectomy (EVT) is the standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO). Young patients with AIS-LVO have distinctly different underlying stroke mechanisms and etiologies. Much is unknown about the safety and efficacy of EVT in this population of young AIS-LVO patients. All consecutive AIS-LVO patients aged 50 years and below were included in this multicenter cohort study. The primary outcome measured was functional recovery at 90 days, with modified Rankin Scale of 0–2 deemed as good functional outcome. A total of 275 AIS-LVO patients that underwent EVT from 10 tertiary centers in Germany, Sweden, Singapore, and Taiwan were included. Successful reperfusion was achieved in 85.1% (234/275). Good functional outcomes were achieved in 66.0% (182/275). Arterial dissection was the most prevalent stroke etiology (42/195, 21.5%). National Institutes of Health Stroke Scale (NIHSS) score at presentation was inversely related to good functional outcomes (aOR: 0.92, 95% CI: 0.88–0.96 per point increase, p < 0.001). Successful reperfusion (aOR: 3.22, 95% CI: 1.44–7.21, p = 0.005), higher ASPECTS (aOR: 1.21, 95% CI: 1.01–1.44, p = 0.036), and bridging intravenous thrombolysis (aOR: 2.37, 95% CI: 1.29–4.34, p = 0.005) independently predicted good functional outcomes. Successful reperfusion was inversely associated with in-hospital mortality (aOR: 0.14, 95% CI: 0.03–0.57, p = 0.006). History of hypertension strongly predicted in-hospital mortality (aOR: 4.59, 95% CI: 1.10–19.13, p = 0.036). While differences in functional outcomes exist across varying stroke aetiologies, high rates of successful reperfusion and good outcomes are generally achieved in young AIS-LVO patients undergoing EVT. © 2021 European Academy of Neurology
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