Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Behme, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeyen, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Psychogios, M. N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kowoll, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maurer, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Joachimski, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liman, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wasser, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlis, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Knauth, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language ACUTE ISCHEMIC-STROKE; SINGLE-CENTER EXPERIENCE; ENDOVASCULAR TREATMENT; INTRACRANIAL THROMBECTOMY; TANDEM OCCLUSIONS; THERAPY; RECANALIZATION; THROMBOLYSIS; RETRIEVER; OUTCOMES Multiple languages Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38573