Behme, D., Mpotsaris, A., Zeyen, P., Psychogios, M. N., Kowoll, A., Maurer, C. J., Joachimski, F., Liman, J., Wasser, K., Kabbasch, C., Berlis, A., Knauth, M., Liebig, T. and Weber, W. (2015). Emergency Stenting of the Extracranial Internal Carotid Artery in Combination with Anterior Circulation Thrombectomy in Acute lschemic Stroke: A Retrospective Multicenter Study. Am. J. Neuroradiol., 36 (12). S. 2340 - 2346. DENVILLE: AMER SOC NEURORADIOLOGY. ISSN 1936-959X

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Abstract

BACKGROUND AND PURPOSE: Several small case series reported a favorable clinical outcome for emergency stent placement in the extracranial internal carotid artery combined with mechanical thrombectomy in acute stroke. The rate of postinterventional symptomatic intracranial hemorrhages was reported to be as high as 20%. Therefore, we investigated the safety and efficacy of this technique in a large multicentric cohort. MATERIALS AND METHODS: The data bases of 4 German stroke centers were screened for all patients who received emergency stent placement of the extracranial internal carotid artery in combination with mechanical thrombectomy of the anterior circulation between 2007 and 2014. The primary outcome measure was the rate of symptomatic intracranial hemorrhage according to the European Cooperative Acute Stroke Study III criteria; secondary outcome measures included the angiographic revascularization results and clinical outcome. RESULTS: One hundred seventy patients with a median age of 64 years (range, 25-88 years) were treated. They presented after a median of 98 minutes (range, 52-160 minutes) with a median NIHSS score of 15 (range, 12-19). Symptomatic intracranial hemorrhages occurred in 15/170 (9%) patients; there was no statistically significant difference among groups pertaining to age, sex, intravenous rtPA, procedural timings, and the rate of successful recanalization. In 130/170(77%) patients, a TICI score of >= 2b could be achieved. The in-hospital mortality rate was 19%, and 36% of patients had a favorable outcome at follow-up. CONCLUSIONS: Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is effective and safe. It is not associated with a significantly higher risk of symptomatic intracranial hemorrhage compared with published series for mechanical thrombectomy alone.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Behme, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mpotsaris, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zeyen, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Psychogios, M. N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kowoll, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maurer, C. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Joachimski, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liman, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wasser, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kabbasch, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlis, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knauth, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebig, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-385738
DOI: 10.3174/ajnr.A4459
Journal or Publication Title: Am. J. Neuroradiol.
Volume: 36
Number: 12
Page Range: S. 2340 - 2346
Date: 2015
Publisher: AMER SOC NEURORADIOLOGY
Place of Publication: DENVILLE
ISSN: 1936-959X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACUTE ISCHEMIC-STROKE; SINGLE-CENTER EXPERIENCE; ENDOVASCULAR TREATMENT; INTRACRANIAL THROMBECTOMY; TANDEM OCCLUSIONS; THERAPY; RECANALIZATION; THROMBOLYSIS; RETRIEVER; OUTCOMESMultiple languages
Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/38573

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