PURPOSE In patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO), endovascular treatment (EVT) is highly effective for emergency revascularization. However, data on functional outcome are lacking for patients, which show no or minimal mismatch between ischemic core and penumbra. METHODS Forty-five patients with AIS due to LVO of the anterior circulation were retrospectively analyzed within 6 h since onset when administered to our department. In all patients, there was no relevant penumbra according to CT perfusion (CTP). Functional outcome, defined by the modified Rankin Scale (mRS) at 30 and 90 days, was analyzed according to LVO treatment (EVT versus non-EVT). Confounding was addressed by multivariable regression analyses. RESULTS mRS values at 30 days (p = 0.002) and 90 days (p = 0.005) after AIS occurrence were significantly lower in patients who had received EVT. There was no significant difference regarding good functional outcome, as measured by mRS of 0-2 at 30 (p = 0.432) and 90 days, respectively (p = 0.186). Mortality was significantly reduced in patients undergoing EVT at 30-day (p < 0.001) and at 90-day follow-up (p = 0.003), respectively. Multivariable regression analyses revealed that EVT was associated with reduced mortality at 30 (OR 0.091; CI (0.013-0.612); p = 0.014) and 90 days (OR 0.134; CI (0.021-0.857); p = 0.034) after AIS. CONCLUSIONS Despite a small and highly selected patient collective, our study indicates that AIS patients with minimal penumbra in CTP might benefit from EVT in terms of reduced mortality at 30 and 90 days after AIS. However, in this group of patients, we could not prove favorable functional outcome at 30 and 90 days, despite receiving EVT.

中文翻译：

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大血管闭塞患者的血管内治疗：尽管半影最小，但死亡率降低。

目的在由大血管闭塞（LVO）引起的急性缺血性中风（AIS）患者中，血管内治疗（EVT）对于紧急血运重建非常有效。但是，患者缺乏功能结局的数据，显示缺血核心和半影之间没有或只有极少的不匹配。方法回顾性分析我科收治的45例因前循环LVO引起的AIS患者自发病起6小时内的情况。在所有患者中，根据CT灌注（CTP）均无相关的半影。根据LVO治疗（EVT与非EVT）分析由改良的Rankin量表（mRS）在30天和90天定义的功能结局。多变量回归分析解决了混淆问题。结果30天（p = 0.002）和90天（p = 0）的mRS值。005）接受EVT的患者发生AIS后明显降低。分别在30天（p = 0.432）和90天（p = 0.186）时，mRS为0-2，对良好的功能结局无显着差异。分别在30天（p <0.001）和90天随访（p = 0.003）进行EVT的患者的死亡率显着降低。多变量回归分析显示，EVT与AIS后30天（OR 0.091; CI（0.013-0.612）; p = 0.014）和90天（OR 0.134; CI（0.021-0.857）; p = 0.034）死亡率降低相关。结论尽管有少量且高度精选的患者群体，但我们的研究表明，CIS半影最少的AIS患者在降低AIS术后30天和90天的死亡率方面可能受益于EVT。但是，在这组患者中