White Matter Disease and Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke

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Figure.
Distribution of the 90-day mRS score according to white matter disease severity graded with the van Swieten scale score.

Table 1:

Baseline characteristics of patients with no-to-minimal (van Sweeten score, 0–2) and moderate-to-severe (van Swieten score, 3–4) white matter disease

	van Swieten 0–2 (n = 315)	van Swieten 3–4 (n = 74)	P Value
Age (mean) (±SD) (yr)	66 (±15)	76 (±12)	<.001
Male (%)	164 (52)	32 (43)	.2
Hypertension (%)	224 (71)	68 (92)	<.001
Diabetes (%)	92 (29)	23 (31)	.78
Glucose (median) (IQR)	122 (102–146)	131 (115–162)	.009
NIHSS (median) (IQR)	15 (10–20)	17 (11–21)	.16
ASPECTS (median) (IQR)	8 (7–10)	8 (7–9)	.07
Core volume (mean) (±SD)	20 (±24)	19 (±26)	.85
Penumbra volume (mean) (±SD)	119 (±71)	124 (±71)	.69
Systolic BP on admission (mean) (± SD)	154 (±29)	168 (±29)	<.001
Time from last known well to reperfusion (median) (IQR)	274 (180–534)	286 (190–676)	.2
Intravenous thrombolysis (%)	160 (51)	29 (39)	.09
Prior stroke (%)	52 (16)	19 (26)	.09

Table 2:

Outcomes of patients with no-to-minimal (van Swieten score, 0–2) and moderate-to-severe (van Swieten score, 3–4) white matter disease

Outcome	van Swieten 0–2 (n = 315)	van Swieten 3–4 (n = 74)	Unadjusted OR with 95% CI	P Value	Adjusted OR with 95% CI	P Value
90-Day mRS 0–2 (%)	141/295 (45)	13/70 (18)	0.25 (0.13–0.46)	<.001	0.37 (0.17–0.75)	.008
90-Day mRS 0–3 (%)	184/295 (58)	29/70 (39)	0.43 (0.25–0.73)	.002	0.75 (0.40–1.43)	.38
Shift in the 90-day mRS	NA	NA	2.86 (1.83–4.52)	<.001	3.05 (1.93–4.84)	<.001
Death (%)	47 (15)	19 (26)	1.97 (1.06–3.57)	.029	1.14 (0.56–2.26)	.71
Symptomatic ICH (%)	13 (4)	4 (5)	1.33 (0.37–3.88)	.629	NA	NA
mTICI ≥ 2b (%)	275 (87)	68 (92)	1.65 (0.72–4.47)	.27	NA	NA
ENI (%)	132 (42)	30 (40)	0.95 (0.56–1.58)	.83	NA	NA

Note:—mTICI indicates modified TICI; ENI, early neurologic improvement; NA, not applicable.

Table 3:

Outcomes of patients with successful recanalization (mTICI ≥ 2b) according to the severity of baseline white matter disease

Outcome	van Swieten 0–2 (n = 275)	van Swieten 3–4 (n = 68)	P Value
90-Day mRS 0–2 (%)	132/258 (52)	13/65 (20)	<.001
90-Day mRS 0–3 (%)	169/258 (65.5)	28/65 (43)	.002
Death (%)	34 (12.4)	17 (25.0)	.013
Symptomatic ICH (%)	10 (3.6)	3 (4.4)	.73
ENI (%)	124 (45.1)	30 (44.1)	1.0