PT  - JOURNAL ARTICLE
AU  - Suh, D.C.
AU  - Kim, J.K.
AU  - Choi, C.G.
AU  - Kim, S.J.
AU  - Pyun, H.W.
AU  - Ahn, C.
AU  - Yang, D.H.
AU  - Lim, K.S.
AU  - Leem, J.-G.
AU  - Hahm, K.D.
AU  - Lee, J.-H.
AU  - Kwon, S.U.
AU  - Kim, J.S.
TI  - Prognostic Factors for Neurologic Outcome after Endovascular Revascularization of Acute Symptomatic Occlusion of the Internal Carotid Artery
AID  - 10.3174/ajnr.A0492
DP  - 2007 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1167--1171
VI  - 28
IP  - 6
4099  - http://www.ajnr.org/content/28/6/1167.short
4100  - http://www.ajnr.org/content/28/6/1167.full
SO  - Am. J. Neuroradiol.2007 Jun 01; 28
AB  - BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion.MATERIALS AND METHODS: We retrospectively evaluated 33 consecutive patients (men/women, 23/10; mean age, 66 years) with: 1) acute symptomatic ICA occlusion within 6 hours of symptom onset or with mismatch of symptoms and an early infarct area, 2) National Institutes of Health Stroke Scale (NIHSS) score of 6 or more, and 3) attempted endovascular revascularization of the occluded ICA. Various single and multiple variable analyses were conducted to assess the association of 14 predictors with short-term (1-month NIHSS) and long-term (1-year modified Rankin Scale [mRS]) outcomes.RESULTS: Successful recanalization (at or more than grade 2 distal residual occlusion) was obtained in 14 (42%) of 33 and good recovery (mRS ≤2) after 1 year in 11 (33%) of 33. Distal residual occlusion (DRO; P = .005), initial NIHSS score (P = .023), and postprocedural thrombolysis in cerebral infarction (P = .027), retrograde ICA filling (P = .036), and ophthalmic collaterals (P = .046) were significant predictors of short-term outcome. DRO (P = .018) and initial NIHSS (P = .033) were significant predictors of long-term outcome on univariable analysis. DRO was the only significant predictor for short-term (P = .026) and long-term outcome (P = .033) on multivariable logistic regression.CONCLUSIONS: Active revascularization of acute symptomatic ICA occlusion resulted in good recovery in one third of patients after 1 year. DRO is an independent predictor of a favorable clinical outcome.