LOW RATE OF STROKE PROGRESSION IN PATIENTS WITH MINOR STROKE AND LARGE VESSEL OCCLUSION

• Main Author: Hubert, Gordian J
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017
• DOI: 10.26226/morressier.5cb58cf7c668520010b567d7

Background and aims:Large vessel occlusion (LVO) in anterior circulation is present in up to 18% of patients with minor stroke. It is unclear which of these patients experience clinical worsening if mechanical thrombectomy (MT) is withheld.Purpose of our analysis was to investigate rate and risk factors for stroke progression in patients with LVO when MT was not performed.Methods:The telemedical stroke network TEMPiS registry was searched for patients with LVO and mild clinical deficit (National Institute of Health Stroke Scale /NIHSS 0-5) in which MT was not performed between 01/2013 and 10/2018. We analyzed frequency of non-haemorrhagic clinical deterioration compatible with stroke progression in the area of the occluded artery (=increase in NIHSS >4) during hospital stay as well as patientsu2019 characteristics.Results:Of 19 patients that were included, 2 (11%) showed clinical deterioration. Of these, 1 had left internal carotid artery (ICA)-occlusion, 1 left tandem-occlusion (ICA/M1 segment of middle cerebral artery). Clinical deterioration did not occur in patients with occlusions of M2-segments of the middle cerebral artery, nor of anterior or posterior cerebral artery. Patients with deterioration compared to those without were older (79y versus 72y), had more often onset beyond 4.5h (50% versus 29%) and had more often cardio embolic cause for stroke (50% versus 24%).Conclusion:Rate of stroke progression in patients with minor stroke caused by large vessel occlusion was low. Age, time from onset, site of occlusion and stroke aetiology may be identifiable risk factors.