Could Endovascular Treatment Benefit Long-Term Outcomes Post Stroke?

Endovascular treatment is associated with better functional outcomes following acute ischemic stroke in the long-term, according to the results of a recent study.

For their extended follow-up trial, researchers assessed clinical outcomes 2 years after patients were randomly assigned to either endovascular treatment or conventional treatment for acute ischemic stroke. Functional outcome was measured using the modified Rankin scale, which ranges from 0 (asymptomatic) to 6 (death).
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Of the 500 patients who participated in the original trial, 2-year data was available for 391 (78.2%) and information on death was available for 459 (91.8%). Overall, Rankin scale scores showed that endovascular treatment was associated with better functional outcomes than conventional treatment, however, there was no significant difference in the percentage of patients with excellent outcomes between the groups.

The mean quality-of-life score was 0.48 among those who received endovascular treatment, compared with 0.38 among those who received conventional treatment, as measured by the European Quality of Life-5 Dimensions questionnaire (ranging from -0.329 to 1). The cumulative 2-year mortality rate was 26% in the endovascular group and 31% in the conventional group.

“In this extended follow-up trial, the beneficial effect of endovascular treatment on functional outcome at 2 years in patients with acute ischemic stroke was similar to that reported at 90 days in the original trial,” the researchers concluded.

—Michael Potts

Reference:

Van den Berg LA, Dijkgraaf MGW, Berkhemer OA, et al. Two-year outcome after endovascular treatment for acute ischemic stroke [published online April 6, 2017]. NEJM. doi: 10.1056/NEJMoa1612136.