Background: Endovascular treatment has demonstrated benefit in functional outcomes after acute stroke but the effect on cognitive outcomes has not been explored yet.
Hypothesis: Our hypothesis is that endovascular treatment is associated with better cognitive outcome after ischemic stroke.
Methods: REVASCAT (Randomized Trial of Revascularization with Solitaire FR Device versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting within Eight Hours of Symptom Onset) enrolled 206 patients with stroke of anterior circulation<8h and without cognitive impairment at onset that were randomized to receive thrombectomy or best medical treatment. Executive function was measured by means of Trail Making tests (TM-A and B) at 90 day. Time of completion of each test and number of errors were recorded.
Results: Excluding deaths, 120 patients were able to complete TM-A in due time (less than 5 min), 61 in thrombectomy and 59 controls (p=NS), and 65 patients could complete TM-B, 39 in thrombectomy and 26 controls (p=0.026). Time required to complete TM-A was not different between groups but controls needed more time (unadjusted Beta,1.0; 95%CI, 0.15-1.84) than thrombectomy patients to complete TM-B.
Conclusion: Patients treated with thrombectomy showed more frequently preserved and faster executive functioning compared to controls 3 months after stroke.