Complete Recovery After Endovascular Treatment. a Predictable Outcome

Background: Multiple randomized trials have demonstrated that endovascular treatment(EVT) in selected stroke patients is associated with good clinical outcome (90 days mRankin 0-2: 33-60%). The percentage of complete functional recovery (mRankin Score: 0) is the most optimist and desirable result after endovascular treatment and their predictor factors are unknown. Methods: Consecutive patients with ischemic stroke who received endovascular reperfusion treatment were retrospectively analyzed between August 2010 and May 2017. We review the percentage of recanalization (TICI 2b-3), good outcome in 90days follow-up(mRS0-2) and complete recovery(mRS 0) after EVT. We evaluate which variables are associated to complete recovery and excellent outcome. Results: We reviewed 802 endovascular treatments. Ninety-five percent of occlusions were located in middle cerebral artery or terminal internal carotid, (45% women, mean age 67+/-13 years; NIHSS at admission 17. Successful recanalization (TICI 2b-3) was achieved in 82%. At 90 days good functional outcome (mRS 0-2) was seen in 51% . A complete functional recovery was achieved in 19% of EVT. We compare patients who achieve 90d mRS:0 vs 90d mR:1-2; in this analysis baseline NIH (14 vs 17) and OSTP (Onset Stroke Time to Puncture: 256 vs 281 min) were predictor variables significantly associated to complete functional recovery after adjustment (p:0.001). Radiologic variables: baseline ASPECTS>9, M1-M2 occlusion, a single pass of stent-retriever and absence of hemorrhagic transformation in 24hCT are related in multivariate analysis to 90d mRS 0. Nine percent of patients showed abscence of infarct in DWI sequence of MRI performed in acute phase of stroke. Conclusions: Excellent functional outcome after thrombectomy could be achieved in highly percentage of patients with short OSTP. Good radiological findings warrant excellent results.