Outcome of endovascular treatment for acute ischemic stroke in Northern Finland

Endovascular treatment revolutionized the management of acute ischemic stroke as it became the standard of care in large vessel occlusion stroke in 2015. The aim of this thesis was to study the differences in the utilization of endovascular therapy for acute ischemic stroke in terms of income and rurality, types and frequency of medical complications, quality of life and long-term mortality in this patient group in Northern Finland.
In Northern Finland the utilization of endovascular therapy was most frequent among high income area patients. Medical complications were recorded in 61% of patients. The most common complications were pneumonia (40%) and cardiac insufficiency (35%). Patients experienced disability in multiple levels. Impairment in social functioning was more distinct among individuals aged above 65 years. At 30 days there were 85% patients alive. Of the 30-day survivors, 16% died during follow-up. Comorbidity, prestroke functional dependence, stroke severity and medical complications were indicative of long term mortality. In conclusion, patient-related factors have significant effect on outcome and mortality after endovascular therapy for acute ischemic stroke. Appropriate patient selection for the intervention and prevention of complications are essential when aiming to improve the outcome in this patient group.