Table 1.
Baseline characteristics, imaging findings, and time management.
| Main analysis; baseline characteristics in tandem occlusions vs. controls | Subgroup analysis; baseline characteristics depending on etiology | ||||||
|---|---|---|---|---|---|---|---|
| TO | Controls | p-value | Dissection | LAD | LAD/CE | p-value | |
| n = 222* | n = = 849 | n = 26 | n = 149 | n = 41 | |||
| DEMOGRAPHICS | |||||||
| Age, mean (SD), years | 67.8 (12.8) | 73.1 (12.9) | < 0.001 | 48.1 (10.7) | 69.2 (10.3) | 75.4 (10.4) | < 0.001 |
| Male sex, n (%) | 151 (68.0) | 394 (46.4) | < 0.001 | 19 (73.1) | 105 (70.5) | 23 (56.1) | 0.194 |
| CARDIOVASCULAR RISK PROFILE, n (%) | |||||||
| Atrial fibrillation | 61 (27.5) | 531 (62.5) | < 0.001 | 0 (n.a.) | 22 (14.8) | 39 (95.1) | < 0.001 |
| Hypertension | 165 (74.3) | 583 (68.7) | 0.118 | 12 (46.2) | 119 (79.9) | 32 (78.0) | 0.002 |
| Diabetes mellitus II | 48 (21.6) | 180 (21.2) | 0.927 | 2 (7.7) | 38 (25.5) | 8 (19.5) | 0.114 |
| Hyperlipidemia | 51 (23.0) | 179 (21.1) | 0.582 | 2 (7.7) | 37 (24.8) | 12 (29.3) | 0.093 |
| Smoking | 52 (23.4) | 73 (8.6) | < 0.001 | 7 (26.9) | 39 (26.2) | 6 (14.6) | 0.307 |
| Coronary artery disease | 48 (21.6) | 231 (27.2) | 0.103 | 2 (7.7) | 27 (18.2) | 19 (47.3) | < 0.001 |
| STROKE ETIOLOGY, n (%) | |||||||
| Atherothrombotic (LAD) | 149 (67.1) | 23 (2.7) | < 0.001 | n.a. | n.a. | n.a. | n.a. |
| Cardioembolic | 0 (n.a.) | 537 (63.3) | < 0.001 | n.a. | n.a. | n.a. | n.a. |
| Dissection | 26 (11.7) | 1 (0.1) | < 0.001 | n.a. | n.a. | n.a. | n.a. |
| ESUS ‡ | 0 (n.a.) | 263 (31.0) | < 0.001 | n.a. | n.a. | n.a. | n.a. |
| LAD/CE (LAD + cardioembolic) | 41 (18.5) | 0 (n.a.) | < 0.001 | n.a. | n.a. | n.a. | n.a. |
| Other etiology | 6 (2.7) | 25 (2.9) | 1.000 | n.a. | n.a. | n.a. | n.a. |
| NIHSS SCORE (BASELINE) | |||||||
| Mean (SD) | 14.8 (8.1) | 16.5 (7.6) | < 0.001 | 14.7 (8.2) | 14.6 (8.5) | 15.9 (7.0) | 0.495 |
| IMAGING MODALITY, n (%) | |||||||
| MRI | 52 (23.7) | 177 (21.2) | 0.462 | 9 (34.2) | 35 (23.8) | 6 (15.0) | 0.204 |
| MOST PROXIMAL VESSEL OCCLUSION, n (%) | |||||||
| ICA | 14 (6.3) | 22 (2.6) | 0.030 | 3 (11.5) | 6 (4.0) | 3 (7.3) | 0.093 |
| Carotid-T | 58 (26.1) | 195 (23.0) | 7 (26.9) | 38 (25.5) | 11 (26.8) | ||
| MCA, M1 | 123 (55.4) | 533 (62.8) | 9 (34.6) | 90 (60.4) | 22 (53.7) | ||
| MCA, M2 | 27 (12.2) | 99 (11.7) | 7 (26.9) | 15 (10.1) | 5 (12.2) | ||
| IVT, n (%) | 53 (23.9) | 269 (31.7) | 0.026 | 7 (26.9) | 39 (26.2) | 5 (12.2) | 0.147 |
| TIME MANAGEMENT (HOURS), MEAN (SD) | |||||||
| Time to recanalization | 6.0 (1.8) | 5.1 (1.5) | < 0.001 | 7.4 (2.3) | 5.6 (1.6) | 6.2 (1.9) | < 0.001 |
| Symptom-onset to groin puncture | 3.6 (1.1) | 3.7 (1.9) | 0.832 | 4.0 (1.3) | 3.5 (1.0) | 3.8 (1.1) | 0.135 |
| Imaging to groin puncture | 2.3 (0.8) | 2.3 (0.8) | 0.531 | 2.3 (1.1) | 2.2 (0.8) | 2.4 (0.8) | 0.343 |
| Duration of treatment | 2.3 (1.6) | 1.1 (1.2) | < 0.001 | 3.4 (2.6) | 2.1 (1.3) | 2.5 (1.5) | < 0.001 |
| THROMBECTOMY DEVICES, n (%) | |||||||
| Penumbra ACE aspiration | 7 (3.2) | 28 (3.3) | 0.220 | 1 (3.8) | 5 (3.4) | 1 (2.4) | 0.142 |
| Solitaire stent retriever | 13 (5.9) | 33 (3.9) | 2 (7.7) | 5 (3.4) | 6 (14.6) | ||
| Phenox stent retriever | 156 (70.3) | 626 (73.7) | 19 (73.1) | 108 (72.5) | 26 (63.4) | ||
| MicroVention aspiration | 33 (14.9) | 105 (12.4) | 2 (7.7) | 25 (16.8) | 4 (9.8) | ||
| Other | 13 (5.9) | 57 (6.8) | 2 (7.7) | 6 (4.1) | 4 (9.8) | ||
| HEMORRHAGIC COMPLICATIONS, n (%) | |||||||
| PH1 | 7 (3.2) | 32 (3.8) | 0.841 | 1 (3.8) | 5 (3.4) | 1 (2.4) | 1.000 |
| PH2 | 9 (4.1) | 33 (3.9) | 0.848 | 0 (n.a.) | 8 (5.4) | 1 (2.4) | 0.655 |
| SAH | 29 (13.1) | 60 (7.1) | 0.006 | 6 (23.1) | 20 (13.4) | 2 (4.9) | 0.091 |
| Successful recanalization (TICI 2b/3), n (%) | 197 (89.1) | 748 (88.3) | 0.813 | 23 (88.5) | 134 (89.9) | 35 (87.5) | 0.834 |
TO, tandem occlusion; LAD, large artery disease/atherothrombotic; LAD/CE, competing etiologies (LAD plus cardiac embolism); SD, standard deviation; IVT, intravenous thrombolysis; PH, parenchymal hemorrhage; SAH, subarachnoid hemorrhage; n.a., not applicable; TICI, Thrombolysis in Cerebral Infarction; NIHSS, National Institutes of Health Stroke Scale.
*
n, total number of patients included in the respective group; might differ from n in any category of baseline characteristics due to missing data.
‡
ESUS, embolic stroke of undetermined source.