PortalPublikationenIncomplete or failed thrombectomy in acute stroke patients w...

Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying?

Standard

Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying? / Broocks, Gabriel; Flottmann, Fabian; Schönfeld, Michael; Bechstein, Matthias; Aye, Pauline; Kniep, Helge; Faizy, Tobias D; McDonough, Rosalie; Schön, Gerhard; Deb-Chatterji, Milani; Thomalla, Götz; Sporns, Peter; Fiehler, Jens; Hanning, Uta; Kemmling, Andre; Meyer, Lukas.

in: EUR J NEUROL, Jahrgang 27, Nr. 10, 27, 10.2020, S. 2031-2035.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Broocks, G, Flottmann, F, Schönfeld, M, Bechstein, M, Aye, P, Kniep, H, Faizy, TD, McDonough, R, Schön, G, Deb-Chatterji, M, Thomalla, G, Sporns, P, Fiehler, J, Hanning, U, Kemmling, A & Meyer, L 2020, 'Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying?', EUR J NEUROL, Jg. 27, Nr. 10, 27, S. 2031-2035. https://doi.org/10.1111/ene.14358

APA

Broocks, G., Flottmann, F., Schönfeld, M., Bechstein, M., Aye, P., Kniep, H., Faizy, T. D., McDonough, R., Schön, G., Deb-Chatterji, M., Thomalla, G., Sporns, P., Fiehler, J., Hanning, U., Kemmling, A., & Meyer, L. (2020). Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying? EUR J NEUROL, 27(10), 2031-2035. [27]. https://doi.org/10.1111/ene.14358

Vancouver

Broocks G, Flottmann F, Schönfeld M, Bechstein M, Aye P, Kniep H et al. Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying? EUR J NEUROL. 2020 Okt;27(10):2031-2035. 27. https://doi.org/10.1111/ene.14358

Bibtex

@article{a38dd8caa3134d29b332e92ea60e2a6d,
title = "Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying?",
abstract = "BACKGROUND AND PURPOSE: It is currently unknown whether mechanical thrombectomy (MT) for ischaemic stroke patients with low initial Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is clinically beneficial or even harmful. The purpose of this study was to investigate whether failed or incomplete MT in acute large vessel occlusion stroke with an initial ASPECTS ≤ 5 is associated with worse clinical outcome compared to patients not undergoing MT.METHODS: This observational cohort study included a consecutive sample of patients with anterior circulation stroke and initial ASPECTS ≤ 5 admitted between March 2015 and August 2019. Failed recanalization was defined as Thrombolysis in Cerebral Infarction (TICI) score 0-2a, and incomplete recanalization as TICI 2b. Clinical outcome was assessed using the modified Rankin Scale (mRS) at 90 days defining very poor clinical outcome as mRS > 4.RESULTS: One hundred and seventy patients were included. Ninety-nine patients underwent MT and 71 patients received best medical treatment only. Clinical outcome after failed or incomplete MT (TICI 0-2b) was significantly better compared to patients with medical treatment only (median mRS 5, interquartile range 4-6 vs 5-6, P = 0.03). In multivariable logistic regression analysis, failed or incomplete MT (TICI 0-2b) showed a significantly reduced likelihood for very poor outcome (odds ratio 0.39, 95% confidence interval 0.19-0.83, P = 0.01). Failed MT (TICI 0-2a) was not associated with a worse outcome compared to best medical treatment.CONCLUSIONS: Patients with failed or incomplete recanalization results (TICI 0-2b) showed a reduced likelihood for very poor outcome compared with those who did not receive MT. Evidence from randomized trials is needed to confirm that even failed or incomplete MT is not harmful in these patients.",
author = "Gabriel Broocks and Fabian Flottmann and Michael Sch{\"o}nfeld and Matthias Bechstein and Pauline Aye and Helge Kniep and Faizy, {Tobias D} and Rosalie McDonough and Gerhard Sch{\"o}n and Milani Deb-Chatterji and G{\"o}tz Thomalla and Peter Sporns and Jens Fiehler and Uta Hanning and Andre Kemmling and Lukas Meyer",
note = "{\textcopyright} 2020 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.",
year = "2020",
month = oct,
doi = "10.1111/ene.14358",
language = "English",
volume = "27",
pages = "2031--2035",
journal = "EUR J NEUROL",
issn = "1351-5101",
publisher = "Wiley-Blackwell",
number = "10",

}

RIS

TY - JOUR

T1 - Incomplete or failed thrombectomy in acute stroke patients with Alberta Stroke Program Early Computed Tomography Score 0-5 - how harmful is trying?

AU - Broocks, Gabriel

AU - Flottmann, Fabian

AU - Schönfeld, Michael

AU - Bechstein, Matthias

AU - Aye, Pauline

AU - Kniep, Helge

AU - Faizy, Tobias D

AU - McDonough, Rosalie

AU - Schön, Gerhard

AU - Deb-Chatterji, Milani

AU - Thomalla, Götz

AU - Sporns, Peter

AU - Fiehler, Jens

AU - Hanning, Uta

AU - Kemmling, Andre

AU - Meyer, Lukas

N1 - © 2020 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

PY - 2020/10

Y1 - 2020/10

N2 - BACKGROUND AND PURPOSE: It is currently unknown whether mechanical thrombectomy (MT) for ischaemic stroke patients with low initial Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is clinically beneficial or even harmful. The purpose of this study was to investigate whether failed or incomplete MT in acute large vessel occlusion stroke with an initial ASPECTS ≤ 5 is associated with worse clinical outcome compared to patients not undergoing MT.METHODS: This observational cohort study included a consecutive sample of patients with anterior circulation stroke and initial ASPECTS ≤ 5 admitted between March 2015 and August 2019. Failed recanalization was defined as Thrombolysis in Cerebral Infarction (TICI) score 0-2a, and incomplete recanalization as TICI 2b. Clinical outcome was assessed using the modified Rankin Scale (mRS) at 90 days defining very poor clinical outcome as mRS > 4.RESULTS: One hundred and seventy patients were included. Ninety-nine patients underwent MT and 71 patients received best medical treatment only. Clinical outcome after failed or incomplete MT (TICI 0-2b) was significantly better compared to patients with medical treatment only (median mRS 5, interquartile range 4-6 vs 5-6, P = 0.03). In multivariable logistic regression analysis, failed or incomplete MT (TICI 0-2b) showed a significantly reduced likelihood for very poor outcome (odds ratio 0.39, 95% confidence interval 0.19-0.83, P = 0.01). Failed MT (TICI 0-2a) was not associated with a worse outcome compared to best medical treatment.CONCLUSIONS: Patients with failed or incomplete recanalization results (TICI 0-2b) showed a reduced likelihood for very poor outcome compared with those who did not receive MT. Evidence from randomized trials is needed to confirm that even failed or incomplete MT is not harmful in these patients.

AB - BACKGROUND AND PURPOSE: It is currently unknown whether mechanical thrombectomy (MT) for ischaemic stroke patients with low initial Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is clinically beneficial or even harmful. The purpose of this study was to investigate whether failed or incomplete MT in acute large vessel occlusion stroke with an initial ASPECTS ≤ 5 is associated with worse clinical outcome compared to patients not undergoing MT.METHODS: This observational cohort study included a consecutive sample of patients with anterior circulation stroke and initial ASPECTS ≤ 5 admitted between March 2015 and August 2019. Failed recanalization was defined as Thrombolysis in Cerebral Infarction (TICI) score 0-2a, and incomplete recanalization as TICI 2b. Clinical outcome was assessed using the modified Rankin Scale (mRS) at 90 days defining very poor clinical outcome as mRS > 4.RESULTS: One hundred and seventy patients were included. Ninety-nine patients underwent MT and 71 patients received best medical treatment only. Clinical outcome after failed or incomplete MT (TICI 0-2b) was significantly better compared to patients with medical treatment only (median mRS 5, interquartile range 4-6 vs 5-6, P = 0.03). In multivariable logistic regression analysis, failed or incomplete MT (TICI 0-2b) showed a significantly reduced likelihood for very poor outcome (odds ratio 0.39, 95% confidence interval 0.19-0.83, P = 0.01). Failed MT (TICI 0-2a) was not associated with a worse outcome compared to best medical treatment.CONCLUSIONS: Patients with failed or incomplete recanalization results (TICI 0-2b) showed a reduced likelihood for very poor outcome compared with those who did not receive MT. Evidence from randomized trials is needed to confirm that even failed or incomplete MT is not harmful in these patients.

U2 - 10.1111/ene.14358

DO - 10.1111/ene.14358

M3 - SCORING: Journal article

C2 - 32449311

VL - 27

SP - 2031

EP - 2035

JO - EUR J NEUROL

JF - EUR J NEUROL

SN - 1351-5101

IS - 10

M1 - 27

ER -