Endovascular thrombectomy associated with improved cognitive outcomes for acute ischemic stroke at 5 months

1. In post-stroke patients, endovascular thrombectomy (EVT) was associated with favourable outcomes on 5 separate cognitive tests that showed benefits to global cognitive function. 

Evidence Rating Level: 2 (Good) 

Endovascular thrombectomy (EVT) is a highly effective treatment for large vessel occlusion strokes that can improve functional neurologic outcomes. While EVT reduces infarct volume, cognitive outcomes have not been well-studied. To validate the quality of EVT therapy, patients were randomized to be treated either with the standard medical therapy or with standard medical therapy and EVT. To assess global cognitive outcome, five separate tests were administered 90 days after stroke: the Montreal Cognitive Assessment (MoCA), the Sunnybrook Neglect Assessment Procedure (SNAP), the Boston Naming Test (BNT), Trail-making test A (Trails A), and Trail-making test B (Trails B). EVT resulted in significantly better performance on all five cognitive tests. EVT was significantly lowered final infarct volume (FIV) which was significantly associated with higher cognitive performance. Even when FIV is controlled for, EVT showed greater cognitive function. Longer-term outcome studies are needed to assess the effect of EVT on post-stroke dementia which can appear in 8.2-34% after 1 year depending on stroke severity. 

Click to read the study in Neurology

Image: PD

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