Table 1.
Baseline characteristics of patients with ischemic stroke caused by three different etiologies
| Characteristic | CA-O (n=149) | AT-O (n=49) | ICAS-O (n=63) | P |
|---|---|---|---|---|
| Age (yr) | 69.7±10.9 | 66.1±10.2 | 66.2±10.7 | 0.034 |
| Male sex | 73 (49.0) | 43 (87.8) | 50 (79.4) | <0.001 |
| Initial NIHSS | 14 (11–17.5) | 10 (7.5–13.5) | 11 (8–15) | <0.001 |
| Hypertension | 91 (61.1) | 29 (59.2) | 45 (71.4) | 0.301 |
| Diabetes | 32 (21.5) | 20 (40.8) | 18 (28.6) | 0.026 |
| Hyperlipidemia | 34 (22.8) | 14 (28.6) | 20 (31.7) | <0.384 |
| Cigarette smoking | 36 (28.8) | 12 (50.0) | 7 (15.2) | 0.010 |
| Previous history of stroke | 29 (19.5) | 14 (28.6) | 14 (22.2) | 0.424 |
| Atrial fibrillation | 122 (81.9) | 0 (0) | 0 (0) | <0.001 |
| Laboratory findings | ||||
| Hemoglobin (g/dL) | 12.9±1.9 | 14.0±1.9 | 14.5±1.9 | <0.001 |
| Total cholesterol (mg/dL) | 168.2±44.0 | 169.0±43.7 | 181.9±37.6 | 0.089 |
| LDL-C (mg/dL) | 107.6±35.8 | 104.0±40.8 | 117.0±34.2 | 0.132 |
| C-reactive protein (mg/dL) | 1.1±2.5 | 0.6±1.8 | 0.9±1.9 | 0.256 |
| Occlusion site | ||||
| Middle cerebral artery | 84 (56.5) | 20 (40.8) | 34 (54.0) | 0.165 |
| M1 | 71 (47.7) | 17 (34.7) | 28 (44.4) | 0.291 |
| M2 | 13 (8.7) | 4 (8.2) | 7 (11.1) | 0.836 |
| Anterior cerebral artery | 4 (2.7) | 1 (2.0) | 0 (0) | 0.483 |
| Posterior circulation arteries | 23 (15.4) | 14 (28.6) | 15 (23.8) | 0.084 |
| Internal carotid artery | 48 (32.2) | 27 (55.1) | 14 (22.2) | 0.001 |
| Clot sign | 67 (45.0) | 11 (22.4) | 25 (39.7) | 0.018 |
| Treatment with intravenous tPA | 54 (36.2) | 12 (24.5) | 14 (22.2) | 0.078 |
| Time variables (min) | ||||
| Onset to admission | 133.0 (43.0–327.5) | 247.0 (111.5–754.0) | 397 (125–733.0) | <0.001 |
| Onset to groin puncture | 282.0 (190.0–522.5) | 773.0 (282.0–1995.0) | 871 (425.0–2,063.0) | <0.001 |
| Onset to recanalization | 356.0 (252.0–584.0) | 847 (371.0–2,065.0) | 944 (511.0–2,155.0) | <0.001* |
| Puncture to recanalization | 55.0 (37.0–77.0) | 62.0 (52.0–89.5) | 78.0 (55.0–107.0) | <0.001† |
| Total intervention | 70.0 (50.5–90.5) | 80.0 (65.0–100.5) | 88.0 (70.0–118.0) | <0.001 |
| Modalities of EVT | ||||
| Stent retriever | 119 (79.9) | 30 (61.2) | 29 (46.0) | <0.001 |
| Suction thrombectomy | 61 (40.9) | 23 (46.9) | 7 (11.1) | <0.001 |
| Angioplasty | 6 (4.0) | 37 (75.5) | 45 (71.4) | <0.001 |
| Stent insertion | 8 (5.4) | 29 (59.2) | 33 (52.4) | <0.001‡ |
| Use of tirofiban | 2 (1.3) | 4 (8.2) | 8 (12.7) | 0.001 |
| Instant re-thrombosis | 1 (0.7) | 4 (8.2) | 9 (14.3) | <0.001 |
| mTICI | 0.033 | |||
| mTICI 0–1 | 10 (6.8) | 3 (6.1) | 1 (1.6) | |
| mTICI 2a | 6 (4.0) | 1 (2.0) | 4 (6.3) | |
| mTICI 2b | 69 (46.3) | 21 (42.9) | 15 (23.8) | |
| mTICI 3 | 64 (43.0) | 24 (45.8) | 43 (68.3) | |
| Successful recanalization (mTICI 2b–3) | 136 (91.3) | 45 (91.8) | 58 (92.1) | >0.999 |
| Recanalization in follow-up images | 127 (94.1) | 37 (90.2) | 47 (81.0) | 0.020 |
| ICH | 66 (44.9) | 14 (31.1) | 14 (22.6) | 0.006 |
| Type of ICH | 0.462 | |||
| Hemorrhagic infarction, 1 | 21 (31.3) | 8 (57.1) | 6 (42.9) | |
| Hemorrhagic infarction, 2 | 23 (34.3) | 4 (28.6) | 5 (35.7) | |
| Parenchymal hematoma, 1 | 10 (14.9) | 2 (14.3) | 2 (14.3) | |
| Parenchymal hematoma, 2 | 13 (19.4) | 0 (0) | 1 (7.1) | |
| Subarachnoid hemorrhage | 3 (2.0) | 0 (0) | 1 (1.7) | >0.999 |
| Any cerebral hemorrhage | 69 (46.9) | 14 (31.1) | 14 (23.3) | 0.004 |
| mRS 0–2 at 3 mo | 55 (36.9) | 26 (53.1) | 26 (41.3) | 0.142 |
| Mortality at 3 mo | 13 (8.7) | 2 (4.1) | 6 (9.5) | 0.552 |
Values are presented as mean±standard deviation, number (%), or median (interquartile range). The three groups were compared using Pearson chi-square tests, one-way analysis of variance (ANOVA) or the Kruskal-Wallis test, whichever was appropriate.
CA-O, occlusion caused by cardioembolism; AT-O, occlusion caused by artery-to-artery embolism; ICAS-O, intracranial arterial steno-occlusion; NIHSS, National Institutes of Health Stroke Scale; LDL-C, low-density lipoprotein cholesterol; tPA, tissue plasminogen activator; EVT, endovascular treatment; mTICI, modified thrombolysis in cerebral infarction; ICH, intracerebral hemorrhage; mRS, modified Rankin Scale.
Onset-to-recanalization time and puncture-to-recanalization time were calculated in patients in whom successful recanalization was achieved;
Stent insertion refers to intracranial stenting in patients with ICAS-O or CA-O and extracranial (proximal) stenting in patients with AT-O.