Table 1.
Baseline characteristics, metrics, and outcomes of patients with PCA occlusion treated with EVT with or without IVT versus IVT alone
| All (n=724) | EVT+/-IVT (n=400) | IVT (n=324) | P | Missing data | |
|---|---|---|---|---|---|
| Baseline characteristics | |||||
| Age (yr) | 74 (64–82) | 74 (64–82) | 75 (65–82) | 0.23 | 0/0/0 |
| Male sex | 418 (57.7) | 228 (57.0) | 190 (58.6) | 0.71 | 0/0/0 |
| Pre-stroke mRS | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0.39 | 0/0/0 |
| 0 | 458 (63.3) | 257 (64.3) | 201 (62.0) | 0.40 | 0/0/0 |
| 1 | 132 (18.2) | 76 (19.0) | 56 (17.3) | - | - |
| 2 | 72 (9.9) | 39 (9.8) | 33 (10.2) | - | - |
| 3 | 62 (8.6) | 28 (7.0) | 34 (10.5) | - | - |
| Hypertension | 539 (74.4) | 305 (76.3) | 234 (72.2) | 0.23 | 0/0/0 |
| Diabetes | 166 (22.9) | 92 (23.0) | 74 (22.8) | 1.00 | 0/0/0 |
| Hyperlipidemia | 330 (45.7) | 171 (42.9) | 159 (49.2) | 0.10 | 2/1/1 |
| Atrial fibrillation | 219 (30.2) | 131 (32.8) | 88 (27.2) | 0.11 | 0/0/0 |
| Current smoker | 104 (16.1) | 51 (15.0) | 53 (17.3) | 0.46 | 78/61/17 |
| Prior stroke | 106 (14.9) | 50 (12.9) | 56 (17.3) | 0.11 | 13-12-1 |
| Coronary heart disease | 122 (17.3) | 64 (16.7) | 58 (17.9) | 0.69 | 17/17/0 |
| Peripheral artery disease | 39 (6.2) | 18 (5.5) | 21 (6.9) | 0.51 | 90/72/18 |
| Dialysis | 27 (4.2) | 16 (4.8) | 11 (3.5) | 0.44 | 75/68/7 |
| Oral anticoagulation | 87 (12.4) | 64 (16.8) | 23 (7.2) | <0.01* | 23/18/5 |
| Statin | 232 (34.6) | 117 (33.0) | 115 (36.4) | 0.37 | 53/45/8 |
| NIHSS on admission | 7 (4–11) | 8 (5–12) | 6 (3–10) | <0.01* | 0/0/0 |
| Baseline visual field defect | 449 (70.0) | 228 (69.3) | 221 (70.8) | 0.73 | 83/71/12 |
| SBP (mm Hg) | 158 (140–176) | 159 (138–175) | 157 (141–176) | 0.80 | 92/73/19 |
| DBP (mm Hg) | 85 (75–97) | 84 (74–97) | 86 (75–98) | 0.31 | 97/77/20 |
| Baseline imaging | |||||
| Imaging modality | |||||
| CT | 656 (92.0) | 349 (89.7) | 307 (94.8) | 0.02* | 11/11/0 |
| MRI | 106 (14.9) | 53 (13.6) | 53 (16.4) | 0.34 | 11/11/0 |
| Perfusion | 437 (61.3) | 230 (59.1) | 207 (63.9) | 0.22 | 11/11/0 |
| pc-ASPECTS | 10 (9–10) | 10 (9–10) | 10 (9–10) | 0.04*† | 0/0/0 |
| Clot location | <0.01* | 0/0/0 | |||
| P1 | 318 (43.9) | 217 (54.3) | 101 (31.2) | - | - |
| P2 | 350 (48.3) | 159 (39.8) | 191 (59.0) | - | - |
| P3 or P4 | 44 (6.1) | 13 (3.3) | 31 (9.6) | - | - |
| PCom | 5 (0.7) | 4 (1.0) | 1 (0.3) | - | - |
| Bilateral | 7 (1.0) | 7 (1.8) | 0 | - | - |
| Perfusion mismatch >20% | 317 (91.6) | 161 (94.2) | 156 (89.1) | 0.12 | 378/229/149 |
| Treatment factors | |||||
| IVT | 488 (67.4) | 164 (41.0) | 324 (100) | <0.01* | 0/0/0 |
| Onset-to-treatment time (h) | 2.9 (1.8–4.7) | 3.8 (2.4–7.2) | 2.3 (1.5–3.3) | <0.01* | 59/54/5 |
| Time to treatment ≤4.5 h | 488 (73.4) | 206 (59.5) | 282 (88.4) | <0.01* | 59/54/5 |
| Wake-up stroke | 138 (19.9) | 106 (27.3) | 32 (10.4) | <0.01* | 29/12/17 |
| First-pass EVT technique | 54 | ||||
| SR | - | 44 (12.7) | - | - | - |
| Aspiration | - | 178 (51.4) | - | - | - |
| Combined SR and aspiration | - | 114 (32.9) | - | - | - |
| Intra-arterial thrombolysis | - | 5 (1.4) | - | - | - |
| Other | - | 5 (1.4) | - | - | - |
| No. of passes | - | 1 (1–2) | - | - | 18 |
| Recanalization | 3 | ||||
| TICI 0-2a | - | 81 (20.4) | - | - | - |
| TICI 2b-3 | - | 316 (79.6) | - | - | - |
| Etiology | 0.04* | 0/0/0 | |||
| Large artery atherosclerosis | 126 (17.4) | 83 (20.8) | 43 (13.3) | - | - |
| Cardioembolism | 285 (39.4) | 148 (37.0) | 137 (42.3) | - | - |
| Small vessel disease | 19 (2.6) | 7 (1.8) | 12 (3.7) | - | - |
| Other | 54 (7.5) | 28 (7.0) | 26 (8.0) | - | - |
| Undetermined | 240 (33.1) | 134 (33.5) | 106 (32.7) | - | - |
| Visual field recovery‡ | 0.62 | 287/156/131‡ | |||
| Complete | 96 (59.3) | 46 (63.9) | 50 (55.6) | - | - |
| Partial | 12 (7.4) | 5 (6.9) | 7 (7.8) | - | - |
| None | 35 (21.6) | 15 (20.8) | 20 (22.2) | - | - |
| Worse | 19 (11.7) | 6 (8.3) | 13 (14.4) | - | - |
Values are presented as median (interquartile range) or n (%).
PCA, posterior cerebral artery; EVT, endovascular thrombectomy; IVT, intravenous thrombolysis; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; SBP, systolic blood pressure; DBP, diastolic blood pressure; CT, computed tomography; MRI, magnetic resonance imaging; pc-ASPECTS, posterior circulation Acute Stroke Prognosis Early CT Score; PCom, posterior communicating artery; SR, stent retriever; TICI, Thrombolysis In Cerebral Infarction.
P<0.05;
The distribution was higher in the IVT group;
Of the 449 patients with visual field defect on the baseline.