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

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

Abstract

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.

Discover over 20,000 new abstracts, posters and presentations from leading academic conferences every month. Stay on top of the latest findings, methodologies and discussions happening in your research field around the world.

Company

Legal

Follow us

© Copyright 2019 Morressier GmbH. All rights reserved.

© Copyright 2019 Morressier GmbH.
All rights reserved.