We use cookies to ensure that we give you the best experience on our website Learn more

Home

Saved research

May 4, 2019

ESOC-2019

THERAPY AND OUTCOME IN PATIENTS WITH M2 SEGMENT OCCLUSION OF THE MIDDLE CEREBRAL ARTERY AND MINOR NEUROLOGICAL DEFICITS

;

Heldner;

M.R.;

Dobrocky;

T.;

Blanquet;

M.;

Scutelnic;

A.;

Volbers;

B.;

Mosimann;

P.J.;

Piechowiak;

E.I.;

Arnold;

M.;

Fischer;

U.;

Jung;

S.;

Gralla;

J.;

Mordasini;

P.

m2 occlusions

mild neurological deficits

therapy modality

iv-thrombolysis

endovascular therapy

Abstract

9

Views

9

Views

Abstract

Fullscreen

thumbnail

Keywords

m2 occlusions

mild neurological deficits

therapy modality

iv-thrombolysis

endovascular therapy

Abstract

BACKGROUND: Therapy modality in patients with M2 segment occlusion of the middle cerebral artery and mild neurological deficits is a matter of debate. METHODS: Patients admitted to our Bernese stroke center between 05/2004-06/2018 with M2 segment occlusion and NIHSS score ≤5 on admission and therapy decision <4.5 hours after symptom onset were continuously included in this study. Neurological deterioration/improvement (defined as at least +1/-1 point change of NIHSS score compared to baseline) and outcome was compared between IV-thrombolysis only vs. endovascular therapy (+/- IV-thrombolysis). RESULTS: Among 114 patients (39.1% women;median age 67.2y), 58.3% received IV-thrombolysis only and 41.7% endovascular therapy (+/-IV-thrombolysis). Baseline characteristics were similar between both groups, except collateral status being worse in IV-thrombolysed patients (p-trend<0.0001). 3-months neurological deterioration occurred in 12 (11.2%), improvement in 84 (78.5%) of patients. Reperfusion status (p-trend=0.489) and symptomatic intracranial haemorrhages (n=1 of 4 in IV-thrombolysed patients; p=0.206) did not significantly differ between both groups. IV-thrombolysis over endovascular therapy (+/-IV-thrombolysis) showed a trend towards better 3-months mRS shift: p=0.085, better favourable 3-months outcome (90.9% vs. 73.9%):OR 3.53 (95%CI:1.22-10.25);p=0.020, similar excellent 3-months outcome (65.2% vs. 50%):p=0.110, similar 3-months survival (95.5% vs. 89.1%):p=0.214, a trend towards less 3-months neurological deterioration (6.3% vs. 18.6%):p=0.057 and similar improvement (81.3% vs. 74.4%):p=0.401 and less 3-months facial palsy: OR 0.39 (95%CI:0.16-0.47);p=0.033 and dysarthria: OR 0.15 (95%CI 0.04-0.58);p=0.006. CONCLUSIONS: Our study found better effectiveness of IV-thrombolysis over endovascular therapy (+/-IV-thrombolysis) in the analysed patient group despite worse collateral status in IV-thrombolysed patients. There is an unmet need for randomized controlled trials in this stroke field.

Company

Legal

Follow us

© Copyright 2019 Morressier GmbH. All rights reserved.

© Copyright 2019 Morressier GmbH.
All rights reserved.