Endovascular therapy for acute stroke is a safe and efficient evolving method: a single-center retrospective analysis

Abstract

Purpose: To determine the clinical outcome in patients undergoing endovascular therapy for acute stroke.

Materials and methods: During the period 2009-2012, 134 patients with acute stroke and normal computed tomography (CT) findings were treated with endovascular therapy at a single center. Based on CT perfusion and CT angiography findings, all patients had large vessel occlusions. Intravenous thrombolysis was used in eligible patients. The recanalization rate, time to recanalization, periprocedural complications, and clinical outcome at discharge from the hospital (National Institutes of Health score, modified Rankin Scale [mRS]) were analyzed.

Results: The recanalization rate during the study interval increased from 70% (2008-2009) to 94% (2011-2012) (P ≤ .01). The procedure time was reduced from 124 minutes (2009) to 43 minutes (2012) (P ≤ .01), and the periprocedural complication rate decreased from 21% (2009) to 2% (2012) (P ≤ .01). Patients in 2009-2010 had a 2.21 times greater probability for an mRS score ≥ 2 after the procedure compared with patients in 2011-2012 (95% confidence interval, 1.0-5.0). If the procedure lasted 15 minutes longer, the prospect for an mRS score ≥2 after the procedure was 1.30 times greater (P = .02).

Conclusions: High recanalization rates, low procedural complications, and improved clinical outcomes were achieved using endovascular therapy in selected patients with acute stroke during a 4-year period. Endovascular therapy is an evolving safe and effective treatment for intracranial large vessel occlusion.