Functional Aplasia of the Contralateral A1 Segment Influences Clinical Outcome in Patients with Occlusion of the Distal Internal Carotid Artery
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Functional Aplasia of the Contralateral A1 Segment Influences Clinical Outcome in Patients with Occlusion of the Distal Internal Carotid Artery. / Fischer, Sebastian; Goertz, Lukas; Weyland, Charlotte S; Khanafer, Ali; Maurer, Christoph J; Zimmermann, Hanna; Fischer, Thomas David; Styczen, Hanna; Tan, Benjamin; Alexandrou, Maria; Lobsien, Donald; Lobsien, Elmar; Thormann, Maximilian; Meyer, Lukas; Abdullayev, Nuran; Fiehler, Jens; Mpotsaris, Anastasios; Papanagiotou, Panagiotis; Yeo, Leonard; Deuschl, Cornelius; Liebig, Thomas; Berlis, Ansgar; Henkes, Hans; Möhlenbruch, Markus; Maus, Volker.
in: J CLIN MED, Jahrgang 11, Nr. 5, 1293, 26.02.2022.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Functional Aplasia of the Contralateral A1 Segment Influences Clinical Outcome in Patients with Occlusion of the Distal Internal Carotid Artery
AU - Fischer, Sebastian
AU - Goertz, Lukas
AU - Weyland, Charlotte S
AU - Khanafer, Ali
AU - Maurer, Christoph J
AU - Zimmermann, Hanna
AU - Fischer, Thomas David
AU - Styczen, Hanna
AU - Tan, Benjamin
AU - Alexandrou, Maria
AU - Lobsien, Donald
AU - Lobsien, Elmar
AU - Thormann, Maximilian
AU - Meyer, Lukas
AU - Abdullayev, Nuran
AU - Fiehler, Jens
AU - Mpotsaris, Anastasios
AU - Papanagiotou, Panagiotis
AU - Yeo, Leonard
AU - Deuschl, Cornelius
AU - Liebig, Thomas
AU - Berlis, Ansgar
AU - Henkes, Hans
AU - Möhlenbruch, Markus
AU - Maus, Volker
PY - 2022/2/26
Y1 - 2022/2/26
N2 - Background: The importance of an A1 aplasia remains unclear in stroke patients. In this work, we analyze the impact of an A1 aplasia contralateral to an acute occlusion of the distal internal carotid artery (ICA) on clinical outcomes. Methods: We conducted a retrospective study of consecutive stroke patients treated with mechanical thrombectomy at 12 tertiary care centers between January 2015 and February 2021 due to an occlusion of the distal ICA. Functional A1 aplasia was defined as the absence of A1 or hypoplastic A1 (>50% reduction to the contralateral site). Functional independence was measured by the modified Rankin Scale (mRS ≤ 2). Results: In total, 81 out of 1068 (8%) patients had functional A1 aplasia contralateral to distal ICA occlusion. Patients with functional contralateral A1 aplasia were more severely affected on admission (median NIHSS 18, IQR 15−23 vs. 17, IQR 13−21; aOR: 0.672, 95% CI: 0.448−1.007, p = 0.054) and post-interventional ischemic damage was larger (median ASPECTS 5, IQR 1−7, vs. 6, IQR 3−8; aOR: 1.817, 95% CI: 1.184−2.789, p = 0.006). Infarction occurred more often within the ipsilateral ACA territory (20/76, 26% vs. 110/961, 11%; aOR: 2.482, 95% CI: 1.389−4.437, p = 0.002) and both ACA territories (8/76, 11% vs. 5/961, 1%; aOR: 17.968, 95% CI: 4.979−64.847, p ≤ 0.001). Functional contralateral A1 aplasia was associated with a lower rate of functional independence at discharge (6/81, 8% vs. 194/965, 20%; aOR: 2.579, 95% CI: 1.086−6.122, p = 0.032) and after 90 days (5/55, 9% vs. 170/723, 24%; aOR: 2.664, 95% CI: 1.031−6.883, p = 0.043). Conclusions: A functional A1 aplasia contralateral to a distal ICA occlusion is associated with a poorer clinical outcome.
AB - Background: The importance of an A1 aplasia remains unclear in stroke patients. In this work, we analyze the impact of an A1 aplasia contralateral to an acute occlusion of the distal internal carotid artery (ICA) on clinical outcomes. Methods: We conducted a retrospective study of consecutive stroke patients treated with mechanical thrombectomy at 12 tertiary care centers between January 2015 and February 2021 due to an occlusion of the distal ICA. Functional A1 aplasia was defined as the absence of A1 or hypoplastic A1 (>50% reduction to the contralateral site). Functional independence was measured by the modified Rankin Scale (mRS ≤ 2). Results: In total, 81 out of 1068 (8%) patients had functional A1 aplasia contralateral to distal ICA occlusion. Patients with functional contralateral A1 aplasia were more severely affected on admission (median NIHSS 18, IQR 15−23 vs. 17, IQR 13−21; aOR: 0.672, 95% CI: 0.448−1.007, p = 0.054) and post-interventional ischemic damage was larger (median ASPECTS 5, IQR 1−7, vs. 6, IQR 3−8; aOR: 1.817, 95% CI: 1.184−2.789, p = 0.006). Infarction occurred more often within the ipsilateral ACA territory (20/76, 26% vs. 110/961, 11%; aOR: 2.482, 95% CI: 1.389−4.437, p = 0.002) and both ACA territories (8/76, 11% vs. 5/961, 1%; aOR: 17.968, 95% CI: 4.979−64.847, p ≤ 0.001). Functional contralateral A1 aplasia was associated with a lower rate of functional independence at discharge (6/81, 8% vs. 194/965, 20%; aOR: 2.579, 95% CI: 1.086−6.122, p = 0.032) and after 90 days (5/55, 9% vs. 170/723, 24%; aOR: 2.664, 95% CI: 1.031−6.883, p = 0.043). Conclusions: A functional A1 aplasia contralateral to a distal ICA occlusion is associated with a poorer clinical outcome.
U2 - 10.3390/jcm11051293
DO - 10.3390/jcm11051293
M3 - SCORING: Journal article
C2 - 35268383
VL - 11
JO - J CLIN MED
JF - J CLIN MED
SN - 2077-0383
IS - 5
M1 - 1293
ER -