Mechanical Thrombectomy in Ischemic Stroke Patients with Severe Pre-Stroke Disability

J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104952. doi: 10.1016/j.jstrokecerebrovasdis.2020.104952. Epub 2020 Jun 5.

Abstract

Frequency and outcomes of mechanical thrombectomy (MT) in clinical practice for patients with severe pre-stroke disability are largely unknown. In this case series, we aim to describe the disability make-up and outcomes of 33 patients with severe pre-stroke disability undergoing MT. Patients with a permanent, severe, pre-stroke disability (modified Rankin Score, mRS, 4-5) were identified from a prospectively-maintained database of consecutive, MT-treated, anterior circulation acute ischemic stroke patients at two comprehensive stroke centers in the United States. We present details on the cause of disability and socio-demographic status as well as procedural and functional outcomes. This study, despite the lack of inferential testing due to limited sample size, provides insight into demographics and outcomes of MT-treated patients with severe pre-stroke disability. Rate of return to functional baseline as well as rates of procedural success and complications were comparable to that reported in the literature for patients without any pre-existing disability.

Keywords: Acute ischemic stroke; All cerebrovascular disease/stroke; Disability; Infarction; Mechanical thrombectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnosis
  • Brain Ischemia / physiopathology
  • Brain Ischemia / therapy*
  • Databases as Topic
  • Disability Evaluation*
  • Disabled Persons*
  • Female
  • Health Status
  • Humans
  • Male
  • Predictive Value of Tests
  • Recovery of Function
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / therapy*
  • Thrombectomy* / adverse effects
  • Time Factors
  • Treatment Outcome
  • United States