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09-05-2024 | Stroke | Vascular-Interventional

The impacts of venous outflow profiles on outcomes among large vessel occlusion patients receiving endovascular treatment in the late window

Authors: Chen Gong, Liping Huang, Jiacheng Huang, Liyuan Chen, Weilin Kong, Yangmei Chen, Fengli Li, Chang Liu

Abstract

Objectives

To investigate the association between venous outflow (VO) profiles and outcomes among acute ischemic stroke caused by anterior circulation large vessel occlusion (AIS-LVO) patients who had undergone endovascular treatment (EVT) in the late window of 6–24 h from stroke onset.

Methods

This was a post-hoc analysis of our preceding RESCUE-BT trial, with findings validated in an external cohort. Baseline computed tomographic angiography (CTA) was performed to assess VO using the Cortical Vein Opacification Score (COVES). The primary clinical outcome was functional independence at 90 days (modified Rankin Scale score of 0–2). The adjusted odd ratio (aOR) and confidence interval (CI) were obtained from multivariable logistic regressions.

Results

A total of 440 patients were included in the present study. After identifying the cutoff of COVES by marginal effects approach, enrolled patients were divided into the favorable VO group (COVES 4–6) and the poor VO (COVES 0–3) group. Multivariable logistic regression analysis showed that favorable VO (aOR 2.25; 95% CI 1.31–3.86; p = 0.003) was associated with functional independence. Similar results were detected in the external validation cohort. Among those with poor arterial collateralization, favorable VO was still an independent predictor of functional independence (aOR 2.09; 95% CI 1.06–4.10; p = 0.032).

Conclusion

The robust VO profile indicated by COVES 4–6 could promote the frequency of functional independence among AIS-LVO patients receiving EVT in the late window, and the prognostic value of VO was independent of the arterial collateral status.

Clinical relevance statement

The robust venous outflow profile was a valid predictor for functional independence among AIS-LVO patients receiving EVT in the late window (6–24 h) and the predictive role of venous outflow did not rely on the status of arterial collateral circulation.

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Title: The impacts of venous outflow profiles on outcomes among large vessel occlusion patients receiving endovascular treatment in the late window
Authors: Chen Gong
Liping Huang
Jiacheng Huang
Liyuan Chen
Weilin Kong
Yangmei Chen
Fengli Li
Chang Liu
Publication date: 09-05-2024
Publisher: Springer Berlin Heidelberg
Keyword: Stroke
Published in: European Radiology
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-024-10742-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impacts of venous outflow profiles on outcomes among large vessel occlusion patients receiving endovascular treatment in the late window

Abstract

Objectives

Methods

Results

Conclusion

Clinical relevance statement

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Clinical relevance statement

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