Clinical Characteristics of Patients with Embolic Stroke of Undetermined Source Treated by Endovascular Recanalization Therapy

Abstract

Objective: This study was carried out to evaluate the clinical characteristics of patients with embolic stroke of undetermined source (ESUS) treated by endovascular reperfusion therapy for emergent large vessel occlusion (ELVO).

Subjects and Methods: Of 87 consecutive acute ischemic stroke patients with ELVO treated by endovascular reperfusion therapy, clinical characteristics, treatments, and outcomes were compared in 14 patients diagnosed with ESUS at discharge and 42 patients with cardioembolic stroke (CES).

Results: In the ESUS group, the patients were younger (63.9 vs. 76.4 years, P <0.05), and the percentage of males was lower (21.4% vs. 64.3%, P <0.05), than in the CES group. Most patients in both groups received mechanical thrombectomy, and there was no significant difference in the National Institutes of Health Stroke Scale (NIHSS) score on admission (median: 17 vs. 18), diffusion weighted image-Alberta Stroke Program Early CT score (DWI-ASPECTS) (median: 8 vs. 7), or successful reperfusion (thrombolysis in cerebral infarction [TICI] grade 2b or 3) rate (78.6% vs. 61.9%). Favorable outcome (modified Rankin Scale [mRS] score of 0-2 at discharge) tended to be more frequent in the ESUS group (71.4% vs. 42.9%, P = 0.06).

Conclusion: The relatively younger age of the ESUS group compared with the CES group is considered to have contributed to the more favorable outcome.