Universität zu Köln

Dorn, F., Prothmann, S., Patzig, M., Lockau, H., Kabbasch, C., Nikoubashman, O., Liebig, T., Zimmer, C., Brueckmann, H., Wiesmann, M., Stetefeld, H., Poppert, H., Reich, A., Kellert, L. and Fesl, G. (2016). Stent Retriever Thrombectomy in Patients Who Are Ineligible for Intravenous Thrombolysis: A Multicenter Retrospective Observational Study. Am. J. Neuroradiol., 37 (2). S. 305 - 311. DENVILLE: AMER SOC NEURORADIOLOGY. ISSN 1936-959X

Full text not available from this repository.

Abstract

BACKGROUND AND PURPOSE: Intravenous thrombolysis with rtPA is the standard of care for patients with acute ischemic stroke within 4.5 hours after symptom onset. However, a considerable number of patients are ineligible for IV thrombolysis due to various contraindications. Recent studies have proved the superiority of mechanical thrombectomy for patients with large-vessel occlusions in combination with IV rtPA compared with IV rtPA alone. We aimed to demonstrate the efficacy of mechanical thrombectomy for patients who are ineligible for IV rtPA. MATERIALS AND METHODS: Patients from the stroke registries of 4 dedicated centers who were treated with mechanical thrombectomy from January 2010 to October 2014 were retrospectively evaluated. Inclusion criteria were the following: acute stroke due to proved large-artery occlusion, ineligibility for IV thrombolysis, and a timeframe of 4.5 hours between stroke and the start of mechanical thrombectomy. Recanalization success, periprocedural complications, clinical outcome, and hemorrhages were evaluated. RESULTS: One hundred thirty endovascular recanalization procedures were identified. The locations were the following: proximal ICA in 17 (13.1%), terminus ICA in 25 (19.2%), M1 segment in 77 (59.2%), and M2 segment in 11 (8.5%). TICI 2b/3 results were achieved in 101 (77.7%), and an mRS score of 0-2 in 47 patients (37.9%). There was a significant correlation between TICI 2b/3 results and good clinical outcomes (87.2% versus 6.8%; P = .048). A good clinical result was most frequent when recanalization was achieved within 4.5 hours (37/74 = 50% versus 10/50 = 20.0%; P = .001). Symptomatic hemorrhage occurred in 13.1% of patients; mortality was 24.2%. Periprocedural complications were recorded in 10 patients (7.7%). CONCLUSIONS: Mechanical thrombectomy can achieve good clinical outcomes in patients with acute large-artery occlusion ineligible for IV thrombolysis, in particular when recanalization is reached early.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dorn, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prothmann, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Patzig, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lockau, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nikoubashman, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmer, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brueckmann, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesmann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stetefeld, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Poppert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reich, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kellert, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fesl, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-285810
DOI:	10.3174/ajnr.A4520
Journal or Publication Title:	Am. J. Neuroradiol.
Volume:	37
Number:	2
Page Range:	S. 305 - 311
Date:	2016
Publisher:	AMER SOC NEURORADIOLOGY
Place of Publication:	DENVILLE
ISSN:	1936-959X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; INTRACEREBRAL ARTERY OCCLUSIONS; TISSUE-PLASMINOGEN-ACTIVATOR; MECHANICAL THROMBECTOMY; ENDOVASCULAR TREATMENT; RANDOMIZED-TRIAL; MERCI TRIAL; RECANALIZATION; INTRAARTERIAL; REVASCULARIZATION Multiple languages Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28581