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Endovascular therapy in acute ischaemic stroke patients with prestroke dependency-an EVA-TRISP cohort study

2026-08-05Artigo científico Acesso aberto
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dc.contributor.authorPiot, Ines
dc.contributor.authorEnz, Lukas S.
dc.contributor.authorAltersberger, Valerian L.
dc.contributor.authorTrüssel, Simon
dc.contributor.authorDe Marchis, Gian Marco
dc.contributor.authorDittrich, Tolga
dc.contributor.authorHeldner, Mirjam R.
dc.contributor.authorHotz, Julian F.
dc.contributor.authorSoekeland, Greta
dc.contributor.authorDobrocky, Tomas
dc.contributor.authorPezzini, Alessandro
dc.contributor.authorMichel, Patrik
dc.contributor.authorStrambo, Davide
dc.contributor.authorSalerno, Alexander
dc.contributor.authorWegener, Susanne
dc.contributor.authorInauen, Corinne
dc.contributor.authorBaumgartner, Philipp
dc.contributor.authorCurtze, Sami
dc.contributor.authorMartinez-Majander, Nicolas
dc.contributor.authorNederkoorn, Paul J.
dc.contributor.authorCoutinho, Jonathan M.
dc.contributor.authorNolte, Christian H.
dc.contributor.authorRiegler, Christoph
dc.contributor.authorPadjen, Visnja
dc.contributor.authorLeker, Ronen R.
dc.contributor.authorJubran, Hamza
dc.contributor.authorWoock, Malin
dc.contributor.authorJood, Katarina
dc.contributor.authorRentzos, Alexandros
dc.contributor.authorCereda, Carlo W.
dc.contributor.authorVabanesi, Marco
dc.contributor.authorZini, Andrea
dc.contributor.authorPaolucci, Matteo
dc.contributor.authorMarto, João Pedro
dc.contributor.authorMartins, Alexandra
dc.contributor.authorMolad, Jeremy
dc.contributor.authorEngelter, Stefan T.
dc.contributor.authorGensicke, Henrik
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblOxford University Press
dc.date.accessioned2026-09-08T14:46:02Z
dc.date.available2026-09-08T14:46:02Z
dc.date.issued2026-08-05
dc.descriptionPublisher Copyright: © The Author(s) 2026. Published by Oxford University Press on behalf of the European Stroke Organisation.
dc.description.abstractINTRODUCTION: Acute EVT may be withheld from stroke patients with prestroke dependency on the help of others in daily activities because of insufficient randomised evidence. Using data from a large registry, we aimed to improve evidence for EVT decision-making in these patients. PATIENTS AND METHODS: Multicentre international observational study from the EndoVascular Therapy and ThRombolysis in Ischemic Stroke Patients (EVA-TRISP) collaboration comparing prestroke-dependent (prestroke mRS 3-4) with prestroke-independent patients (prestroke mRS 0-2). We used multivariate logistic regression analysis and report odds ratios (ORs) and 95% CIs. Outcomes were poor functional outcome in survivors (defined relative to the prestroke mRS), 3 month mortality, sICH occurrence and unsuccessful recanalisation. RESULTS: Of 13,525 eligible patients, 1436 (10.6%) were prestroke-dependent. These patients were older (median 84 vs 73 years), more often women (61.0% vs 46.7%) and had higher NIHSS score (median 16 vs 14 points). While the odds of death (ORadjusted 2.33 [95% CI, 2.04-2.66]; 48.6% vs 19.6%) and unsuccessful recanalisation (ORadjusted 1.16 [95% CI, 1.02-1.33]; 31.0% vs 26.6%) were higher in prestroke-dependent patients, there was no evidence of increased odds of poor functional outcome in survivors (ORadjusted 0.68 [95% CI, 0.57-0.81]; 42.8% vs 40.0%) and sICH (ORadjusted 0.72 [95% CI, 0.53-0.98]; 3.8% vs 4.6%). DISCUSSION AND CONCLUSIONS: Despite higher mortality and recanalisation failure, prestroke-dependent patients did not have worse functional outcomes among survivors or higher sICH risk. This suggests that EVT should not be withheld solely on the basis of prestroke dependency.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent2333392
dc.identifier.doi10.1093/esj/aakag099
dc.identifier.issn2396-9873
dc.identifier.otherPURE: 171900515
dc.identifier.otherPURE UUID: dabe12fc-2b60-4170-8ec5-a628e989172e
dc.identifier.otherScopus: 105047838314
dc.identifier.otherPubMed: 42627880
dc.identifier.urihttp://hdl.handle.net/10362/206184
dc.identifier.urlhttps://www.scopus.com/pages/publications/105047838314
dc.language.isoeng
dc.peerreviewedyes
dc.subjectfunctional outcome
dc.subjectmechanical thrombectomy success
dc.subjectmortality
dc.subjectmRS
dc.subjectreal-world registry
dc.subjectsICH
dc.subjectClinical Neurology
dc.subjectCardiology and Cardiovascular Medicine
dc.titleEndovascular therapy in acute ischaemic stroke patients with prestroke dependency-an EVA-TRISP cohort studyen
dc.typejournal article
degois.publication.issue8
degois.publication.titleEuropean Stroke Journal
degois.publication.volume11
dspace.entity.typePublication
rcaap.rightsopenAccess

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