Clinical Outcome After Mechanical Thrombectomy in Patients with Diabetes with Major Ischemic Stroke of the Anterior Circulation

BACKGROUND: Among patients with acute ischemic stroke treated with mechanical thrombectomy (MT), patients with diabetes (DP) show a poorer outcome compared with patients without diabetes (NDP). This study aims to provide a comprehensive analysis of factors associated with unfavorable outcome in DP receiving MT for stroke of the anterior circulation. METHODS: This study included 317 of 498 consecutive patients who received interventional treatment for acute ischemic stroke in the terminal internal carotid artery and/or middle cerebral artery, including 46 DP. The study data included pre- and posttreatment stroke computed tomography, including perfusion data, collateral status, treatment data including treatment times, pre-existing cardiovascular risk factors, cerebrovascular events, comorbidities, laboratory parameters, and medication. Neurologic status was assessed at baseline (National Institute of Health Stroke Scale [NIHSS]/ modified Rankin Scale [mRS]) and after 90 days (mRS 90). RESULTS: Compared with NDP, DP showed a significantly poorer outcome (mRS90 >2) (P 2) in DP was associated with poor collaterals (P = 0.01) and hyperglycemia on admission (P = 132 mg/dl) and older age (>= 66 years) showed a particularly poor outcome. CONCLUSIONS: The main factors for an unfavorable outcome of DP after MT are admission hyperglycemia, age, and NIHSS score