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SHR Neuro Cancer Cardio Lipid Metab Microb

Sykora, M; Poli, S; Giannakakis, M; Mbroh, J; Exposito, AG; Krebs, S; Posekany, A; Katan, M; Wegener, S; De, Marchis, GM; Gattringer, T; Deutschmann, HA; Mayer-Suess, L; Fiehler, J; Ernemann, U; Hennersdorf, F; Dobrocky, T; Kulcsár, Z; Mordasini, P; Psychogios, M; Loewe, C; Gizewski, ER; Nolte, CH; Neumann, C; Fischer, U; Ferrari, J, , CONCORDIA, investigators.
Functional Outcome in Patients With Carotid Artery Dissection Undergoing Thrombectomy or Standard Medical Treatment.
Neurology. 2025; 104(7): e213465 Doi: 10.1212/WNL.0000000000213465
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Co-authors Med Uni Graz

Deutschmann Hannes

Gattringer Thomas

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Abstract:

BACKGROUND AND OBJECTIVES: Whether thrombectomy compared with best medical treatment (BMT) improves outcome in patients with stroke and carotid artery dissection (CAD) is unknown. METHODS: This was an international observational study based on prospective nationwide Austrian, German, and Swiss stroke registries. Patients with large vessel occlusion (LVO) due to CAD were compared according to treatment modality (thrombectomy vs BMT including intravenous thrombolysis) and to admission stroke severity NIH Stroke Scale (NIHSS) <6 vs NIHSS ≥6. The primary outcome was the favorable functional outcome (modified Rankin Score 0-2) at 3 months. RESULTS: Of 1,023 patients (mean age 54 years, 72% males), 516 received thrombectomy and 507 received BMT. After robust adjustment, thrombectomy was associated with favorable outcome in patients presenting with NIHSS ≥6 (adjusted risk ratio (aRR) = 1.77, 95% CI 1.44-2.17). In those presenting with NIHSS <6, thrombectomy was associated with unfavorable outcome (aRR 1.68, CI 1.1-2.56) as compared with BMT. DISCUSSION: Thrombectomy improved functional outcome in patients with LVO due to CAD and admission NIHSS ≥6, but not NIHSS <6 points. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with LVO due to CAD and admission NIHSS ≥6 points, thrombectomy compared with BMT significantly increases the probability of favorable outcome.

Find related publications in this database (using NLM MeSH Indexing)

Humans - administration & dosage

Male - administration & dosage

Female - administration & dosage

Middle Aged - administration & dosage

Thrombectomy - methods

Treatment Outcome - administration & dosage

Registries - administration & dosage

Aged - administration & dosage

Prospective Studies - administration & dosage

Adult - administration & dosage

Stroke - surgery, therapy

Carotid Artery, Internal, Dissection - surgery, therapy

Thrombolytic Therapy - administration & dosage

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