Universität zu Köln

Styczen, Hanna ORCID: 0000-0002-9623-4156, Maegerlein, Christian, Yeo, Leonard L. L., Clajus, Christin, Kastrup, Andreas, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Behme, Daniel, Maurer, Christoph Johannes, Meyer, Lukas ORCID: 0000-0002-3776-638X, Goertz, Lukas, Ikenberg, Benno, Tan, Benjamin Y. Q., Lobsien, Donald, Papanagiotou, Panagiotis, Kabbasch, Christoph, Hesse, Amelie Carolina, Berlis, Ansgar, Fiehler, Jens, Fischer, Sebastian, Forsting, Michael and Maus, Volker (2020). Repeated mechanical thrombectomy in short-term large vessel occlusion recurrence: multicenter study and systematic review of the literature. J. NeuroInterventional Surg., 12 (12). S. 1186 - 1194. LONDON: BMJ PUBLISHING GROUP. ISSN 1759-8486

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Abstract

Background Data on the frequency and outcome of repeated mechanical thrombectomy (MT) in patients with short-term re-occlusion of intracranial vessels is limited. Addressing this subject, we report our multicenter experience with a systematic review of the literature. Methods A retrospective analysis was conducted of consecutive acute stroke patients treated with MT repeatedly within 30 days at 10 tertiary care centers between January 2007 and January 2020. Baseline demographics, etiology of stroke, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at 90 days were noted. Additionally, a systematic review of reports with repeated MT due to large vessel occlusion (LVO) recurrence was performed. Results We identified 30 out of 7844 (0.4%) patients who received two thrombectomy procedures within 30 days due to recurrent LVO. Through systematic review, three publications of 28 participants met the criteria for inclusion. Combined, a total of 58 participants were analyzed: cardioembolic events were the most common etiology for the first (65.5%) and second LVO (60.3%), respectively. Median baseline NIHSS (National Institutes of Health Stroke Scale) was 13 (IQR 8-16) before the first MT and 15 (IQR 11-19) before the second MT (p=0.031). Successful reperfusion was achieved in 91.4% after the first MT and in 86.2% patients after the second MT (p=0.377). The rate of functional independence (mRS 0-2) was 46% at 90 days after the second procedure. Conclusion Repeated MT in short-term recurrent LVO is a rarity but appears to be safe and effective. The second thrombectomy should be pursued with the same extensive effort as the first procedure as these patients may achieve similar good outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Styczen, Hanna UNSPECIFIED orcid.org/0000-0002-9623-4156 UNSPECIFIED Maegerlein, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Yeo, Leonard L. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Clajus, Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kastrup, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED Behme, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Maurer, Christoph Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Lukas UNSPECIFIED orcid.org/0000-0002-3776-638X UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Ikenberg, Benno UNSPECIFIED UNSPECIFIED UNSPECIFIED Tan, Benjamin Y. Q. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lobsien, Donald UNSPECIFIED UNSPECIFIED UNSPECIFIED Papanagiotou, Panagiotis UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Hesse, Amelie Carolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlis, Ansgar UNSPECIFIED UNSPECIFIED UNSPECIFIED Fiehler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Forsting, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-310298
DOI:	10.1136/neurintsurg-2020-015938
Journal or Publication Title:	J. NeuroInterventional Surg.
Volume:	12
Number:	12
Page Range:	S. 1186 - 1194
Date:	2020
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1759-8486
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; ENDOVASCULAR THROMBECTOMY; METAANALYSIS; GUIDELINES Multiple languages Neuroimaging; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31029