Singer, Oliver C., Berkefeld, Joachim, Nolte, Christian H., Bohner, Georg ORCID: 0000-0002-1919-092X, Haring, Hans-Peter, Trenkler, Johannes ORCID: 0000-0001-6060-4234, Groeschel, Klaus, Mueller-Forell, Wibke, Niederkorn, Kurt, Deutschmann, Hannes ORCID: 0000-0003-4552-699X, Neumann-Haefelin, Tobias, Hohmann, Carina, Bussmeyer, Matthias, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Stoll, Anett, Bormann, Albrecht, Brenck, Johannes, Schlamann, Marc U., Jander, Sebastian, Turowski, Bernd, Petzold, Gabor C., Urbach, Horst and Liebeskind, David S. (2015). Mechanical Recanalization in Basilar Artery Occlusion: The ENDOSTROKE Study. Ann. Neurol., 77 (3). S. 415 - 425. HOBOKEN: WILEY. ISSN 1531-8249

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Abstract

ObjectiveA study was undertaken to evaluate clinical and procedural factors associated with outcome and recanalization in endovascular stroke treatment (EVT) of basilar artery (BA) occlusion. MethodsENDOSTROKE is an investigator-initiated multicenter registry for patients undergoing EVT. This analysis includes 148 consecutive patients with BA occlusion, with 59% having received intravenous thrombolysis prior to EVT. Recanalization (defined as Thrombolysis in Cerebral Infarction [TICI] score 2b-3) and collateral status (using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral grading system) were assessed by a blinded core laboratory. Good (moderate) outcome was defined as a modified Rankin Scale score of 0 to 2 (0-3) assessed after at least 3 months (median time to follow-up=120 days). ResultsThirty-four percent had good and 42% had moderate clinical outcome; mortality was 35%. TICI 2b-3 recanalization was achieved by 79%. Age, hypertension, National Institutes of Health Stroke Scale scores, collateral status, and the use of magnetic resonance imaging prior to EVT predicted clinical outcome, the latter 3 remaining independent predictors in multivariate analysis. Independent predictors of recanalization were better collateral status and the use of a stent retriever. However, recanalization did not significantly predict clinical outcome. InterpretationBeside initial stroke severity, the collateral status predicts clinical outcome and recanalization in BA occlusion. Our data suggest that the use of a stent retriever is associated with high recanalization rates, but recanalization on its own does not predict outcome. The role of other modifiable factors, including the choice of pretreatment imaging modality and time issues, warrants further investigation. Ann Neurol 2015;77:415-424

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Singer, Oliver C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berkefeld, JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nolte, Christian H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bohner, GeorgUNSPECIFIEDorcid.org/0000-0002-1919-092XUNSPECIFIED
Haring, Hans-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trenkler, JohannesUNSPECIFIEDorcid.org/0000-0001-6060-4234UNSPECIFIED
Groeschel, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller-Forell, WibkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Niederkorn, KurtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deutschmann, HannesUNSPECIFIEDorcid.org/0000-0003-4552-699XUNSPECIFIED
Neumann-Haefelin, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hohmann, CarinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bussmeyer, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mpotsaris, AnastasiosUNSPECIFIEDorcid.org/0000-0002-1275-8164UNSPECIFIED
Stoll, AnettUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bormann, AlbrechtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brenck, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlamann, Marc U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jander, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Turowski, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petzold, Gabor C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Urbach, HorstUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebeskind, David S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-411538
DOI: 10.1002/ana.24336
Journal or Publication Title: Ann. Neurol.
Volume: 77
Number: 3
Page Range: S. 415 - 425
Date: 2015
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1531-8249
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACUTE ISCHEMIC-STROKE; INTRAARTERIAL THROMBOLYSIS; INTERNATIONAL-COOPERATION; BLOOD-FLOW; THROMBECTOMY; REVASCULARIZATION; MANAGEMENT; PREDICTORS; STANDARDS; OUTCOMESMultiple languages
Clinical Neurology; NeurosciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/41153

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