Leukoaraiosis severity and outcomes after mechanical thrombectomy with stent-retriever devices in acute ischemic stroke

J Neurointerv Surg. 2019 Feb;11(2):137-140. doi: 10.1136/neurintsurg-2018-014018. Epub 2018 Jul 24.

Abstract

Background and purpose: The aim of the study was to evaluate whether leukoaraiosis severity is associated with outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.

Methods: In this retrospective multicenter study, we evaluated 251 acute stroke patients (pretreatment National Institutes of Health Stroke Scale score ≥8) treated with stent-retriever devices. Leukoaraiosis severity was graded as 0-2 (absent-to-moderate) versus 3-4 (severe) according to the van Swieten scale. The main clinical outcome was the proportion of good functional outcome, defined as a modified Rankin Scale of 0-2 at 90 days.

Results: Significantly fewer patients in the severe LA group than in the absent-to-moderate LA group achieved a good functional outcome (18.4% vs 50.2%, P<0.001). In multivariable analysis, severe leukoaraiosis was a significant negative predictor of good functional outcome at 90 days (OR, 0.27; 95% CI 0.10-0.77; P=0.014).

Conclusions: The severity of leukoaraiosis is independently associated with 90-day functional outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.

Keywords: leukoaraiosis; stroke; thrombectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / therapy*
  • Device Removal / methods
  • Device Removal / trends
  • Female
  • Humans
  • Leukoaraiosis / diagnostic imaging
  • Leukoaraiosis / therapy*
  • Male
  • Mechanical Thrombolysis / methods
  • Mechanical Thrombolysis / trends*
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index*
  • Stents*
  • Stroke / diagnostic imaging
  • Stroke / therapy*
  • Thrombectomy / methods
  • Thrombectomy / trends
  • Treatment Outcome