BACKGROUND Many patients with large vessel occlusion (LVO) who are otherwise candidates for endovascular treatment (EVT) have had previous strokes. We aimed to examine the effect of previous stroke on outcome after EVT. METHODS Consecutive patients with LVO were prospectively entered into a National Acute Stroke registry of patients undergoing EVT. Patients treated with EVT were divided into those with and without previous strokes. The rates of favorable reperfusion status, mortality, and excellent outcome at 90 days post-stroke as well as symptomatic intracranial hemorrhage (sICH) were evaluated. RESULTS A total of 390 underwent EVT and 35 had previous strokes. Patients with previous strokes were significantly older; more frequently had a history of prior myocardial infarction and more often had pre-existing functional disability. Favorable target vessel recanalization was less frequently achieved in patients with previous strokes (60% vs. 82%; p = 0.005) and ordinal regression analysis for functional outcome revealed higher frequency of deterioration at three months in patients with previous strokes. Nevertheless, 9% of these patients maintained their previous disability state and sICH rates did not differ between the groups. Mortality rates at one year post stroke were significantly higher in patients with previous strokes (37% vs. 16%; p = 0.005). CONCLUSIONS Previous strokes are associated with higher likelihoods of mortality and unfavorable outcome in patients with LVO undergoing EVT. However, because some of these patients maintain their previous disability state, the presence of previous stroke should not be used as an exclusion criterion from EVT.

中文翻译：

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大血管阻塞患者血栓切除术后前次卒中对预后的影响。

背景技术许多大血管闭塞（LVO）患者原本是中风，但他们原本是进行血管内治疗（EVT）的候选人。我们的目的是检查上一次卒中对EVT后结局的影响。方法将LVO的连续患者前瞻性纳入接受EVT的国家急性卒中登记册。用EVT治疗的患者分为既往有卒中和没有卒中的患者。评价了中风后90天的有利的再灌注状态，死亡率和优异的结局率，以及有症状的颅内出血（sICH）。结果共有390例患者接受了EVT，其中35例曾发生过中风。曾有过中风的患者年龄较大；更常有先前的心肌梗塞病史，更常有先前存在的功能障碍。先前卒中患者的目标血管再通率较低（60％vs. 82％； p = 0.005），并且对功能结局的序数回归分析显示，卒中患者三个月恶化的频率更高。然而，这些患者中有9％保持了先前的残疾状态，两组之间的sICH率没有差异。卒中前一年的死亡率明显高于先前卒中的患者（37％比16％； p = 0.005）。结论先前的卒中与接受EVT的LVO患者更高的死亡率和不利的预后相关。但是，由于其中一些患者保持了先前的残疾状态，因此不应将先前卒中的存在作为EVT的排除标准。