Early recurrence of ischemic stroke in patients receiving endovascular thrombectomy.
BACKGROUND/PURPOSE
Endovascular thrombectomy (EVT) is effective in treating acute ischemic stroke associated with large vessel occlusion. Early recurrence of ischemic stroke (ERIS) after EVT, however, is a devastating event and could worsen the condition of patient. Current study aimed to investigate the prevalence and risk factors of ERIS after EVT.


METHODS
The medical records of all patients receiving EVT at a single medical center were reviewed and analyzed. ERIS was defined as presentation of newly developed neurological deficits in previously recanalized vascular territory or another vascular territory that was not initially involved within 30 days of the index stroke.


RESULTS
From January 2015 to September 2018, a total of 200 patients (71.6 ± 12.3 years, male 49%) had received EVT and 17 patients (8.5%) developed ERIS. Presence of valvular heart disease was the only clinical factor associated with ERIS (OR: 4.26, 95% CI: 1.16-17.7). Patients with ERIS had significantly worse modified Rankin scale at 3 months (common OR: 3.11, 95% CI: 1.18-8.73) and were independently associated with mortality (OR: 7.73, 95% CI: 2.00-30.6). Ten of 17 patients with ERIS had received repeated EVT and all achieved good recanalization without procedure-related complications or symptomatic intracerebral hemorrhage.


CONCLUSION
ERIS in patients receiving EVT was not rare, especially in those with valvular heart disease, and was associated with worse outcome. Nevertheless, they could be safely treated by repeated EVT.
['Hsueh|Sung-Ju|SJ|', 'Chen|Chih-Hao|CH|', 'Yeh|Shin-Joe|SJ|', 'Lin|Yen-Heng|YH|', 'Tsai|Li-Kai|LK|', 'Lee|Chung-Wei|CW|', 'Tang|Sung-Chun|SC|', 'Jeng|Jiann-Shing|JS|']
D000368:Aged D000369:Aged, 80 and over D002545:Brain Ischemia D057510:Endovascular Procedures D005260:Female D006801:Humans D000083242:Ischemic Stroke D008297:Male D008875:Middle Aged D020521:Stroke D017131:Thrombectomy D016896:Treatment Outcome
Stroke Thrombectomy Recurrent event Thrombolysis