PT  - JOURNAL ARTICLE
AU  - Raoult, H.
AU  - Lassalle, M.V.
AU  - Parat, B.
AU  - Rousseau, C.
AU  - Eugène, F.
AU  - Vannier, S.
AU  - Evain, S.
AU  - Le Bras, A.
AU  - Ronziere, T.
AU  - Ferre, J.C.
AU  - Gauvrit, J.Y.
AU  - Laviolle, B.
TI  - DWI-Based Algorithm to Predict Disability in Patients Treated with Thrombectomy for Acute Stroke
AID  - 10.3174/ajnr.A6379
DP  - 2020 Feb 01
TA  - American Journal of Neuroradiology
PG  - 274--279
VI  - 41
IP  - 2
4099  - http://www.ajnr.org/content/41/2/274.short
4100  - http://www.ajnr.org/content/41/2/274.full
SO  - Am. J. Neuroradiol.2020 Feb 01; 41
AB  - BACKGROUND AND PURPOSE: The reasons for poor clinical outcome after thrombectomy for acute stroke, concerning around half of all patients, are misunderstood. We developed a hierarchic algorithm based on DWI to better identify patients at high risk of disability.MATERIALS AND METHODS: Our single-center, retrospective study included consecutive patients with acute ischemic stroke who underwent thrombectomy for large anterior artery occlusion and underwent pretreatment DWI. The primary outcome was the mRS at 3 months after stroke onset. Multivariable regression was used to identify independent clinical and imaging predictors of poor prognosis (mRS > 2) at 3 months, and a hierarchic algorithm predictive of disability was developed.RESULTS: A total of 149 patients were analyzed. In decreasing importance, DWI lesion volume of >80 mL, baseline NIHSS score of >14, age older than 75 years, and time from stroke onset to groin puncture of >4 hours were independent predictors of poor prognosis. The predictive hierarchic algorithm developed from the multivariate analysis predicted the risk of disability at 3 months for up to 100% of patients with a high predictive value. The area under the receiver operating characteristic curve was 0.87.CONCLUSIONS: The DWI-based hierarchic algorithm we developed is highly predictive of disability at 3 months after thrombectomy and is easy to use in routine practice.