Conflict of interest: All authors hereby declare they have no conflicts of interest.
Occlusion site does not impact outcome in patients with carotid stroke undergoing endovascular reperfusion
Article first published online: 10 NOV 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 10, Issue 4, pages 560–564, June 2015
How to Cite
Leker, R. R., Eichel, R., Keigler, G., Gomori, J. M. and Cohen, J. E. (2015), Occlusion site does not impact outcome in patients with carotid stroke undergoing endovascular reperfusion. International Journal of Stroke, 10: 560–564. doi: 10.1111/ijs.12192
- Issue published online: 14 MAY 2015
- Article first published online: 10 NOV 2013
- Manuscript Accepted: 5 AUG 2013
- Manuscript Received: 17 MAR 2013
- Peritz and Chantal Scheinberg Cerebrovascular Research Fund
- Sol Irwin Juni Trust Fund
- carotid occlusion;
It remains unclear whether occlusion site impacts outcome in patients with acute carotid artery occlusions.
Patients with acute carotid artery occlusion that underwent endovascular reperfusion treatments were prospectively enrolled. Patients with extracranial carotid bifurcation occlusions were compared with those with intracranial carotid-T-occlusions. Collected data included demographics, risk factor profile, and procedure-related variables. Neurological deficits were studied with the National Institutes of Health Stroke Scale and outcome was studied with the modified Rankin Score at day 90 after stroke and dichotomized into favorable (≤2) or unfavorable (>3). Recanalization status was studied with the thrombolysis in cerebral infarction scale.
We included 51 patients (33 with extracranial bifurcation occlusion and 18 with intracranial T-occlusion). Patients with T lesions were significantly older (median 74 versus 56 years, P = 0·02), more frequently had atrial fibrillation (61% versus 18%; P = 0·005) and cardioembolism (78% versus 21% P = 0·001), smoked less often (6% versus 42%; P = 0·01), and less often required stent implantation (11% versus 48%; P = 0·015). However, neurological severity, other procedure and peri-procedure-related variables including recanalization rates and percentages of symptomatic hemorrhages did not differ between the groups. Mortality rates (24% versus 23%) and chances for favorable outcomes (33% versus 24%) did not significantly differ. On multivariate logistic regression analysis, occlusion location was not a significant modifier of outcome.
Despite differences in stroke risk factors and treatments used between patients with extracranial bifurcation and intracranial T-occlusions, lesion location in itself does not influence outcome in patients with acute carotid artery occlusion treated with endovascular reperfusion.