Endovascular intervention for acute thromboembolic stroke in young patients: An ideal population for aggressive intervention? Clinical article

J. Mocco, Rabih G. Tawk, Babak S. Jahromi, Rodney M. Samuelson, Adnan H. Siddiqui, L. Nelson Hopkins, Elad I. Levy

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Object. Endovascular treatment of acute thromboembolic stroke is a rapidly developing field that appears to hold great promise. Young patients may be particularly suited to benefit from endovascular acute stroke therapy. The au thors sought to identify outcomes in young patients with thromboembolic stroke who underwent endovascular intervention. Methods. The authors retrospectively reviewed a prospectively collected endovascular intervention registry of patients with ischemic strokes treated at a single large-volume institution between December 2000 and June 2007 to identify patients 18-35 years of age who were treated for thromboembolic stroke. Data are presented as the mean ± standard deviation unless otherwise noted. Results. Seven young patients underwent 8 consecutive endovascular interventions for thromboembolic stroke (mean age 26 ± 6 years; 5 women). The National Institutes of Health Stroke Scale score at presentation was 13 ± 4.3 (median 13). All patients presented within 6 hours of symptom onset. Revascularization was attempted with mechanical thrombectomy/disruption, intraarterial thrombolysis, and/or angioplasty, with or without stent placement. The modified Rankin Scale (mRS) score at discharge was 2.2 ± 1.5 (median 1.5), with 5 patients (62.5%) achieving independence at discharge (mRS Score 0-2). There were no deaths. Hospital length of stay was 6.5 ± 3.7 days (4.4 ± 1.5 days for patients with an mRS score of 0-2; 10 ± 3.6 days for patients with an mRS score of 4). All patients became independent and had reached an mRS score of ≤ 2 at last follow-up evaluation (29 ± 25 months). Conclusions. The data demonstrate the relative safety of endovascular intervention in young patients with thromboembolic cerebral ischemia and may suggest a potential benefit in outcome. Further investigation is indicated with larger numbers of patients and an appropriate control population.

Original languageEnglish (US)
Pages (from-to)30-34
Number of pages5
JournalJournal of Neurosurgery
Volume110
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Stroke
Population
Length of Stay
Thrombectomy
National Institutes of Health (U.S.)
Brain Ischemia
Angioplasty
Stents
Registries
Safety
Therapeutics

Keywords

  • Ischemic stroke
  • Reperfusion
  • Thromboembolic stroke
  • Young adult

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Clinical Neurology

Cite this

Mocco, J. ; Tawk, Rabih G. ; Jahromi, Babak S. ; Samuelson, Rodney M. ; Siddiqui, Adnan H. ; Hopkins, L. Nelson ; Levy, Elad I. / Endovascular intervention for acute thromboembolic stroke in young patients : An ideal population for aggressive intervention? Clinical article. In: Journal of Neurosurgery. 2009 ; Vol. 110, No. 1. pp. 30-34.
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abstract = "Object. Endovascular treatment of acute thromboembolic stroke is a rapidly developing field that appears to hold great promise. Young patients may be particularly suited to benefit from endovascular acute stroke therapy. The au thors sought to identify outcomes in young patients with thromboembolic stroke who underwent endovascular intervention. Methods. The authors retrospectively reviewed a prospectively collected endovascular intervention registry of patients with ischemic strokes treated at a single large-volume institution between December 2000 and June 2007 to identify patients 18-35 years of age who were treated for thromboembolic stroke. Data are presented as the mean ± standard deviation unless otherwise noted. Results. Seven young patients underwent 8 consecutive endovascular interventions for thromboembolic stroke (mean age 26 ± 6 years; 5 women). The National Institutes of Health Stroke Scale score at presentation was 13 ± 4.3 (median 13). All patients presented within 6 hours of symptom onset. Revascularization was attempted with mechanical thrombectomy/disruption, intraarterial thrombolysis, and/or angioplasty, with or without stent placement. The modified Rankin Scale (mRS) score at discharge was 2.2 ± 1.5 (median 1.5), with 5 patients (62.5{\%}) achieving independence at discharge (mRS Score 0-2). There were no deaths. Hospital length of stay was 6.5 ± 3.7 days (4.4 ± 1.5 days for patients with an mRS score of 0-2; 10 ± 3.6 days for patients with an mRS score of 4). All patients became independent and had reached an mRS score of ≤ 2 at last follow-up evaluation (29 ± 25 months). Conclusions. The data demonstrate the relative safety of endovascular intervention in young patients with thromboembolic cerebral ischemia and may suggest a potential benefit in outcome. Further investigation is indicated with larger numbers of patients and an appropriate control population.",
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Endovascular intervention for acute thromboembolic stroke in young patients : An ideal population for aggressive intervention? Clinical article. / Mocco, J.; Tawk, Rabih G.; Jahromi, Babak S.; Samuelson, Rodney M.; Siddiqui, Adnan H.; Hopkins, L. Nelson; Levy, Elad I.

In: Journal of Neurosurgery, Vol. 110, No. 1, 01.01.2009, p. 30-34.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endovascular intervention for acute thromboembolic stroke in young patients

T2 - An ideal population for aggressive intervention? Clinical article

AU - Mocco, J.

AU - Tawk, Rabih G.

AU - Jahromi, Babak S.

AU - Samuelson, Rodney M.

AU - Siddiqui, Adnan H.

AU - Hopkins, L. Nelson

AU - Levy, Elad I.

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AB - Object. Endovascular treatment of acute thromboembolic stroke is a rapidly developing field that appears to hold great promise. Young patients may be particularly suited to benefit from endovascular acute stroke therapy. The au thors sought to identify outcomes in young patients with thromboembolic stroke who underwent endovascular intervention. Methods. The authors retrospectively reviewed a prospectively collected endovascular intervention registry of patients with ischemic strokes treated at a single large-volume institution between December 2000 and June 2007 to identify patients 18-35 years of age who were treated for thromboembolic stroke. Data are presented as the mean ± standard deviation unless otherwise noted. Results. Seven young patients underwent 8 consecutive endovascular interventions for thromboembolic stroke (mean age 26 ± 6 years; 5 women). The National Institutes of Health Stroke Scale score at presentation was 13 ± 4.3 (median 13). All patients presented within 6 hours of symptom onset. Revascularization was attempted with mechanical thrombectomy/disruption, intraarterial thrombolysis, and/or angioplasty, with or without stent placement. The modified Rankin Scale (mRS) score at discharge was 2.2 ± 1.5 (median 1.5), with 5 patients (62.5%) achieving independence at discharge (mRS Score 0-2). There were no deaths. Hospital length of stay was 6.5 ± 3.7 days (4.4 ± 1.5 days for patients with an mRS score of 0-2; 10 ± 3.6 days for patients with an mRS score of 4). All patients became independent and had reached an mRS score of ≤ 2 at last follow-up evaluation (29 ± 25 months). Conclusions. The data demonstrate the relative safety of endovascular intervention in young patients with thromboembolic cerebral ischemia and may suggest a potential benefit in outcome. Further investigation is indicated with larger numbers of patients and an appropriate control population.

KW - Ischemic stroke

KW - Reperfusion

KW - Thromboembolic stroke

KW - Young adult

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