• Sònia Abilleira, Pere Cardona, Marc Ribó, Mònica Millán, Víctor Obach, Jaume Roquer, David Cánovas, Joan Martí-Fàbregas, Francisco Rubio, José Alvarez-Sabín, Antoni Dávalos, Angel Chamorro, Maria Angeles de Miquel, Alejandro Tomasello, Carlos Castaño, Juan M Macho, Aida Ribera, Miquel Gallofré, and Catalan Stroke Code and Reperfusion Consortium.
• From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Spain (S.A., A.R., M.G.); Hospital de Bellvitge, L'Hospitalet de Llobregat, Spain (P.C., F.R., M.A.d.M.); Hospital Vall d'Hebron, Barcelona, Spain (M.R., J.A.-S., A.T.); Hospital Germans Trias i Pujol, Badalona, Spain (M.M., A.D., C.C.); Hospital Clínic i Provincial, Barcelona, Spain (V.O., A.C., J.M.M.); Hospital del Mar, Barcelona, Spain (J.R.); Hospital de Sabadell, Sabadell, Spain (D.C.); and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (J.M.-F.).
• Stroke. 2014 Apr 1;45(4):1046-52.

Background And PurposeWe sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome.MethodsWe used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusion therapies for consecutive patients with acute ischemic stroke since 2011. We described outcomes overall and by subgroups (age ≤ or >80 years; onset-to-groin puncture ≤ or >6 hours; anterior or posterior strokes; previous IV recombinant tissue-type plasminogen activator or isolated endovascular treatment/therapy; revascularization or no revascularization), and determined independent predictors of good outcome (modified Rankin Scale score ≤2) and mortality at 3 months by multivariate modeling.ResultsWe analyzed 536 patients, of whom 285 received previous IV recombinant tissue-type plasminogen activator. Overall, revascularization (modified Thrombolysis In Cerebral Infarction scores, 2b and 3) occurred in 73.9%, 5.6% developed symptomatic intracerebral hemorrhages, 43.3% achieved good functional outcome, and 22.2% were dead at 90 days. Adjusted comparisons by subgroups systematically favored revascularization (lower proportion of symptomatic intracerebral hemorrhages and death rates and higher proportion of good outcome). Multivariate analyses confirmed the independent protective effect of revascularization. Additionally, age >80 years, stroke severity, hypertension (deleterious), atrial fibrillation, and onset-to-groin puncture ≤6 hours (protective) also predicted good outcome, whereas lack of previous disability and anterior circulation strokes (protective) as well as and hypertension (deleterious) independently predicted mortality.ConclusionsThis study reinforces the role of revascularization and time to treatment to achieve enhanced functional outcomes and identifies other clinical features that independently predict good/fatal outcome after endovascular treatment/therapy.

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