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Observational Study
. 2025 Apr 8;104(7):e213465.
doi: 10.1212/WNL.0000000000213465. Epub 2025 Mar 14.

Functional Outcome in Patients With Carotid Artery Dissection Undergoing Thrombectomy or Standard Medical Treatment

Marek Sykora  1 , Sven Poli  2 , Michael Giannakakis  3 , Joshua Mbroh  2 , Alexandra Gomez Exposito  2 , Stefan Krebs  4 , Alexandra Posekany  5 , Mira Katan  3 , Susanne Wegener  6 , Gian Marco De Marchis  7 , Thomas Gattringer  8   9 , Hannes A Deutschmann  9 , Lukas Mayer-Suess  10 , Jens Fiehler  11 , Ulrike Ernemann  12 , Florian Hennersdorf  12 , Tomas Dobrocky  13 , Zsolt Kulcsár  14 , Pasquale Mordasini  15 , Marios Psychogios  16 , Christian Loewe  17 , Elke R Gizewski  18 , Christian H Nolte  19 , Christian Neumann  20 , Urs Fischer  3   21 , Julia Ferrari  4 ; CONCORDIA investigators
Collaborators, Affiliations
Observational Study

Functional Outcome in Patients With Carotid Artery Dissection Undergoing Thrombectomy or Standard Medical Treatment

Marek Sykora et al. Neurology. .

Erratum in

  • Functional Outcome in Patients With Carotid Artery Dissection Undergoing Thrombectomy or Standard Medical Treatment.
    Sykora M, Poli S, Giannakakis M, Mbroh J, Exposito AG, Krebs S, Posekany A, Katan M, Wegener S, De Marchis GM, Gattringer T, Deutschmann HA, Mayer-Suess L, Fiehler J, Ernemann U, Hennersdorf F, Dobrocky T, Kulcsár Z, Mordasini P, Psychogios M, Loewe C, Gizewski ER, Nolte CH, Neumann C, Fischer U, Ferrari J; CONCORDIA investigators. Sykora M, et al. Neurology. 2025 Jun 24;104(12):e213825. doi: 10.1212/WNL.0000000000213825. Epub 2025 May 22. Neurology. 2025. PMID: 40403223 No abstract available.

Abstract

Background and objectives: Whether thrombectomy compared with best medical treatment (BMT) improves outcome in patients with stroke and carotid artery dissection (CAD) is unknown.

Methods: This was an international observational study based on prospective nationwide Austrian, German, and Swiss stroke registries. Patients with large vessel occlusion (LVO) due to CAD were compared according to treatment modality (thrombectomy vs BMT including intravenous thrombolysis) and to admission stroke severity NIH Stroke Scale (NIHSS) <6 vs NIHSS ≥6. The primary outcome was the favorable functional outcome (modified Rankin Score 0-2) at 3 months.

Results: Of 1,023 patients (mean age 54 years, 72% males), 516 received thrombectomy and 507 received BMT. After robust adjustment, thrombectomy was associated with favorable outcome in patients presenting with NIHSS ≥6 (adjusted risk ratio (aRR) = 1.77, 95% CI 1.44-2.17). In those presenting with NIHSS <6, thrombectomy was associated with unfavorable outcome (aRR 1.68, CI 1.1-2.56) as compared with BMT.

Discussion: Thrombectomy improved functional outcome in patients with LVO due to CAD and admission NIHSS ≥6, but not NIHSS <6 points.

Classification of evidence: This study provides Class III evidence that for patients with LVO due to CAD and admission NIHSS ≥6 points, thrombectomy compared with BMT significantly increases the probability of favorable outcome.

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