Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases
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Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases. / Styczen, Hanna; Maus, Volker; Goertz, Lukas; Köhrmann, Martin; Kleinschnitz, Christoph; Fischer, Sebastian; Möhlenbruch, Markus; Mühlen, Iris; Kallmünzer, Bernd; Dorn, Franziska; Lakghomi, Asadeh; Gawlitza, Matthias; Kaiser, Daniel; Klisch, Joachim; Lobsien, Donald; Rohde, Stefan; Ellrichmann, Gisa; Behme, Daniel; Thormann, Maximilian; Flottmann, Fabian; Winkelmeier, Laurens; Gizewski, Elke R; Mayer-Suess, Lukas; Boeckh-Behrens, Tobias; Riederer, Isabelle; Klingebiel, Randolf; Berger, Björn; Schlunz-Hendann, Martin; Grieb, Dominik; Khanafer, Ali; du Mesnil de Rochemont, Richard; Arendt, Christophe; Altenbernd, Jens; Schlump, Jan-Ulrich; Ringelstein, Adrian; Sanio, Vivian Jean Marcel; Loehr, Christian; Dahlke, Agnes Maria; Brockmann, Carolin; Reder, Sebastian; Sure, Ulrich; Li, Yan; Mühl-Benninghaus, Ruben; Rodt, Thomas; Kallenberg, Kai; Durutya, Alexandru; Elsharkawy, Mohamed; Stracke, Paul; Schumann, Mathias Gerhard; Bock, Alexander; Nikoubashman, Omid; Wiesmann, Martin; Henkes, Hans; Mosimann, Pascal J; Chapot, René; Forsting, Michael; Deuschl, Cornelius.
in: J NEUROINTERV SURG, Jahrgang 14, Nr. 9, 09.2022, S. 858-862.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases
AU - Styczen, Hanna
AU - Maus, Volker
AU - Goertz, Lukas
AU - Köhrmann, Martin
AU - Kleinschnitz, Christoph
AU - Fischer, Sebastian
AU - Möhlenbruch, Markus
AU - Mühlen, Iris
AU - Kallmünzer, Bernd
AU - Dorn, Franziska
AU - Lakghomi, Asadeh
AU - Gawlitza, Matthias
AU - Kaiser, Daniel
AU - Klisch, Joachim
AU - Lobsien, Donald
AU - Rohde, Stefan
AU - Ellrichmann, Gisa
AU - Behme, Daniel
AU - Thormann, Maximilian
AU - Flottmann, Fabian
AU - Winkelmeier, Laurens
AU - Gizewski, Elke R
AU - Mayer-Suess, Lukas
AU - Boeckh-Behrens, Tobias
AU - Riederer, Isabelle
AU - Klingebiel, Randolf
AU - Berger, Björn
AU - Schlunz-Hendann, Martin
AU - Grieb, Dominik
AU - Khanafer, Ali
AU - du Mesnil de Rochemont, Richard
AU - Arendt, Christophe
AU - Altenbernd, Jens
AU - Schlump, Jan-Ulrich
AU - Ringelstein, Adrian
AU - Sanio, Vivian Jean Marcel
AU - Loehr, Christian
AU - Dahlke, Agnes Maria
AU - Brockmann, Carolin
AU - Reder, Sebastian
AU - Sure, Ulrich
AU - Li, Yan
AU - Mühl-Benninghaus, Ruben
AU - Rodt, Thomas
AU - Kallenberg, Kai
AU - Durutya, Alexandru
AU - Elsharkawy, Mohamed
AU - Stracke, Paul
AU - Schumann, Mathias Gerhard
AU - Bock, Alexander
AU - Nikoubashman, Omid
AU - Wiesmann, Martin
AU - Henkes, Hans
AU - Mosimann, Pascal J
AU - Chapot, René
AU - Forsting, Michael
AU - Deuschl, Cornelius
N1 - © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND: Data on the frequency and outcome of mechanical thrombectomy (MT) for large vessel occlusion (LVO) in patients with COVID-19 is limited. Addressing this subject, we report our multicenter experience.METHODS: A retrospective cohort study was performed of consecutive acute stroke patients with COVID-19 infection treated with MT at 26 tertiary care centers between January 2020 and November 2021. Baseline demographics, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at discharge and 90 days were noted.RESULTS: We identified 111 out of 11 365 (1%) patients with acute or subsided COVID-19 infection who underwent MT due to LVO. Cardioembolic events were the most common etiology for LVO (38.7%). Median baseline National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT Score were 16 (IQR 11.5-20) and 9 (IQR 7-10), respectively. Successful reperfusion (mTICI ≥2b) was achieved in 97/111 (87.4%) patients and 46/111 (41.4%) patients were reperfused completely. The procedure-related complication rate was 12.6% (14/111). Functional independence was achieved in 20/108 (18.5%) patients at discharge and 14/66 (21.2%) at 90 days follow-up. The in-hospital mortality rate was 30.6% (33/108). In the subgroup analysis, patients with severe acute COVID-19 infection requiring intubation had a mortality rate twice as high as patients with mild or moderate acute COVID-19 infection. Acute respiratory failure requiring ventilation and time interval from symptom onset to groin puncture were independent predictors for an unfavorable outcome in a logistic regression analysis.CONCLUSION: Our study showed a poor clinical outcome and high mortality, especially in patients with severe acute COVID-19 infection undergoing MT due to LVO.
AB - BACKGROUND: Data on the frequency and outcome of mechanical thrombectomy (MT) for large vessel occlusion (LVO) in patients with COVID-19 is limited. Addressing this subject, we report our multicenter experience.METHODS: A retrospective cohort study was performed of consecutive acute stroke patients with COVID-19 infection treated with MT at 26 tertiary care centers between January 2020 and November 2021. Baseline demographics, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at discharge and 90 days were noted.RESULTS: We identified 111 out of 11 365 (1%) patients with acute or subsided COVID-19 infection who underwent MT due to LVO. Cardioembolic events were the most common etiology for LVO (38.7%). Median baseline National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT Score were 16 (IQR 11.5-20) and 9 (IQR 7-10), respectively. Successful reperfusion (mTICI ≥2b) was achieved in 97/111 (87.4%) patients and 46/111 (41.4%) patients were reperfused completely. The procedure-related complication rate was 12.6% (14/111). Functional independence was achieved in 20/108 (18.5%) patients at discharge and 14/66 (21.2%) at 90 days follow-up. The in-hospital mortality rate was 30.6% (33/108). In the subgroup analysis, patients with severe acute COVID-19 infection requiring intubation had a mortality rate twice as high as patients with mild or moderate acute COVID-19 infection. Acute respiratory failure requiring ventilation and time interval from symptom onset to groin puncture were independent predictors for an unfavorable outcome in a logistic regression analysis.CONCLUSION: Our study showed a poor clinical outcome and high mortality, especially in patients with severe acute COVID-19 infection undergoing MT due to LVO.
U2 - 10.1136/neurintsurg-2022-018723
DO - 10.1136/neurintsurg-2022-018723
M3 - SCORING: Journal article
C2 - 35292572
VL - 14
SP - 858
EP - 862
JO - J NEUROINTERV SURG
JF - J NEUROINTERV SURG
SN - 1759-8478
IS - 9
ER -