Universität zu Köln

Behme, Daniel, Kabbasch, Christoph, Kowoll, Annika, Dorn, Franziska ORCID: 0000-0001-9093-8307, Liebig, Thomas, Weber, Werner and Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 (2016). Intravenous Thrombolysis Facilitates Successful Recanalization with Stent-Retriever Mechanical Thrombectomy in Middle Cerebral Artery Occlusions. J. Stroke Cerebrovasc. Dis., 25 (4). S. 954 - 960. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1532-8511

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Abstract

Aim: Several factors influence the outcome after acute ischemic stroke secondary to proximal occlusions of cerebral vessels. Among others, noneligibility for intravenous thrombolysis (IVT) and incomplete revascularization have been identified as predictors of unfavorable outcome. The aim of this study was to investigate whether concomitant IVT influences the revascularization efficacy in mechanical thrombectomy (MT). Methods: This study conducted a retrospective analysis of all consecutive patients presenting with an anterior circulation stroke due to large-artery occlusion with imaging evidence who were treated with MT between July 2012 and December 2013 at 2 high-volume stroke centers. Imaging data were regraded and re-evaluated according to the modified Treatment in Cerebral Ischemia scale and its respective vessel occlusion site definitions. Clinical end points included National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale; imaging and procedural measures were technical end points. Results: We identified 93 patients who presented with an occlusion of the middle cerebral artery (MCA): of these patients, 66 (71%) received IVT. We did not find statistically significant differences in the baseline NIHSS score, time from symptom onset to groin puncture, and age when comparing the IVT group with the non-IVT group. The rate of successful recanalizations (modified Treatment in Cerebral Ischemia score >= 2b) was significantly higher in patients with MCA occlusion and concomitant IVT (P = .01). Stepwise logistic regression identified IVT and thrombus length as predictive factors for successful mechanical recanalization (P = .004, P = .002). Conclusion: IVT and thrombus length are predictive factors for a successful recanalization in MT for acute ischemic stroke with underlying MCA occlusion.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Behme, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kowoll, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Werner UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-280562
DOI:	10.1016/j.jstrokecerebrovasdis.2016.01.007
Journal or Publication Title:	J. Stroke Cerebrovasc. Dis.
Volume:	25
Number:	4
Page Range:	S. 954 - 960
Date:	2016
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	1532-8511
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; TISSUE-PLASMINOGEN-ACTIVATOR; RANDOMIZED-TRIAL; CLINICAL-OUTCOMES; THROMBUS LENGTH; REVASCULARIZATION; REPERFUSION; AGE Multiple languages Neurosciences; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28056