Abstract
Objective: The objective of this study was to report on patient outcomes in a mAIS population who received IAT.
Background: Despite suffering mild acute ischemic strokes (mAIS, NIHSS≤7), patients have a non-zero risk of morbidity and mortality. Intra-arterial therapy (IAT) is clearly effective in moderate-to-severe AISs, but we have limited knowledge about its efficacy in mAISs.
Design/Methods: We included all adults (≥18) with a mAIS admitted over 6.5 years to a high-volume comprehensive stroke center and who received IAT. Patients were excluded for any contraindication to IAT (n=240). Outcomes were symptomatic ICH (sICH), in-hospital mortality, discharge mRS ≤2, and an improvement in NIHSS at discharge (>2 vs ≤2).
Results: There were 55 patients included in the study. Overall, patients were predominately aged 55–79 years, admitted with an NIHSS 4–7, or had hypertension. 72% of patients either had a cardioembolic or large vessel occlusion (LVO), and 73% arrived either 0h to 4.5h, or >6h to <12h from symptom onset. 15 patients also received IV-tPA. There were no sICHs. Mortality was 9%; a majority of deaths were in males, patients with ages 55–79, LVOs, or an early symptom to arrival time. 42% of patients showed a 3-point improvement in NIHSS at discharge; a majority of these patients were white, aged 55–79, or had hyperlipidemia. Ultimately, 45% were discharged with an mRS ≥2. There were no cerebral artery perforations or groin complications.
Conclusions: These data highlight the safety of IAT in patients with mAIS, mirroring the results seen in recent large RCTs in the non-mAIS population. Patients in our study had a zero risk of sICH, and a mortality rate similar to literature examining IV-tPA administration in patients with mAIS. Furthermore, a large proportion of patients showed a clinically meaningful improvement in NIHSS, or were discharged with a favorable mRS.
Disclosure: Dr. Fanale has nothing to disclose. Dr. Orlando has nothing to disclose. Dr. Frei has received personal compensation for activities with Microvention, Covidien, Stryker, Siemens and Penumbra as a consultant. Dr. Bellon has received personal compensation for activities with Penumbra. Dr. Wagner has received personal compensation for activities with Genentech as a speaker. Dr. Jensen has nothing to disclose. Dr. Bartt has nothing to disclose. Dr. van Vliet has nothing to disclose. Dr. McCarthy has nothing to disclose. Dr. Bar-Or has nothing to disclose.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
