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Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review

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Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review. / Kaesmacher, Johannes; Meyer, Lukas; Styczen, Hanna; Lobsien, Donald; Seker, Fatih; Piechowiak, Eike; Tan, Benjamin Y Q; Fischer, Sebastian; Clajus, Christin; Yeo, Leonard; Papanagiotou, Panagiotis; Kastrup, Andreas; Maegerlein, Christian; Wunderlich, Silke; Möhlenbruch, Markus A; Radbruch, Alexander; Gralla, Jan; Fiehler, Jens; Maus, Volker.

in: STROKE, Jahrgang 51, Nr. 9, 09.2020, S. e232-e237.

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

Harvard

Kaesmacher, J, Meyer, L, Styczen, H, Lobsien, D, Seker, F, Piechowiak, E, Tan, BYQ, Fischer, S, Clajus, C, Yeo, L, Papanagiotou, P, Kastrup, A, Maegerlein, C, Wunderlich, S, Möhlenbruch, MA, Radbruch, A, Gralla, J, Fiehler, J & Maus, V 2020, 'Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review', STROKE, Jg. 51, Nr. 9, S. e232-e237. https://doi.org/10.1161/STROKEAHA.120.029629

APA

Kaesmacher, J., Meyer, L., Styczen, H., Lobsien, D., Seker, F., Piechowiak, E., Tan, B. Y. Q., Fischer, S., Clajus, C., Yeo, L., Papanagiotou, P., Kastrup, A., Maegerlein, C., Wunderlich, S., Möhlenbruch, M. A., Radbruch, A., Gralla, J., Fiehler, J., & Maus, V. (2020). Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review. STROKE, 51(9), e232-e237. https://doi.org/10.1161/STROKEAHA.120.029629

Vancouver

Kaesmacher J, Meyer L, Styczen H, Lobsien D, Seker F, Piechowiak E et al. Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review. STROKE. 2020 Sep;51(9):e232-e237. https://doi.org/10.1161/STROKEAHA.120.029629

Bibtex

@article{030897ce38ec4c298d3d885536b3983c,
title = "Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review",
abstract = "BACKGROUND AND PURPOSE: Acute ischemic stroke caused by primary multivessel occlusions (pMVO) is a rare but devastating disease. Whether multi-target mechanical thrombectomy for pMVO is beneficial remains unknown.METHODS: Multicenter retrospective review of patients treated with multi-target mechanical thrombectomy. The following pMVO sites were included: basilar artery, internal carotid artery, and middle cerebral artery (M1 and M2). Baseline characteristics were reported together with interventional technique, technical efficacy, and safety parameters. Clinical outcomes were evaluated applying the National Institutes of Health Stroke Scale and modified Rankin Scale. A systematic literature review was performed to summarize previous reports on pMVO mechanical thrombectomy.RESULTS: Of 6081 patients screened, 21 patients met the inclusion criteria (0.35% [95% CI, 0.23%-0.53%]). In 70% (14/20) a cardioembolic cause was reported. A successful reperfusion of Thrombolysis in Cerebral Infarction scale score ≥2b was achieved in 95.2% (20/21) for the first and 76.1% (16/21) for the second target vessel. In those who survived the acute hospital stay (n=10/21), median admission National Institutes of Health Stroke Scale improved from 21 (interquartile range, 13-27) to 8 (interquartile range, 2-20) at discharge (P=0.006). Mortality was 60% (12/20) at 90 days and only 20% (4/20) of patients reached modified Rankin Scale score ≤2. Acceptable outcomes were almost exclusively observed in pMVO patients presenting with at least one M2 occlusion.CONCLUSIONS: Multi-target mechanical thrombectomy for pMVOs is rarely performed; however, the procedure appears to be feasible and safe with high reperfusion rates for both occlusion sites. More than half of all treated patients deceased early and favorable outcomes may only be expected for pMVO patients including at least one M2 occlusion.",
author = "Johannes Kaesmacher and Lukas Meyer and Hanna Styczen and Donald Lobsien and Fatih Seker and Eike Piechowiak and Tan, {Benjamin Y Q} and Sebastian Fischer and Christin Clajus and Leonard Yeo and Panagiotis Papanagiotou and Andreas Kastrup and Christian Maegerlein and Silke Wunderlich and M{\"o}hlenbruch, {Markus A} and Alexander Radbruch and Jan Gralla and Jens Fiehler and Volker Maus",
year = "2020",
month = sep,
doi = "10.1161/STROKEAHA.120.029629",
language = "English",
volume = "51",
pages = "e232--e237",
journal = "STROKE",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

RIS

TY - JOUR

T1 - Primary Multivessel Occlusions Treated With Mechanical Thrombectomy: A Multicenter Analysis and Systemic Literature Review

AU - Kaesmacher, Johannes

AU - Meyer, Lukas

AU - Styczen, Hanna

AU - Lobsien, Donald

AU - Seker, Fatih

AU - Piechowiak, Eike

AU - Tan, Benjamin Y Q

AU - Fischer, Sebastian

AU - Clajus, Christin

AU - Yeo, Leonard

AU - Papanagiotou, Panagiotis

AU - Kastrup, Andreas

AU - Maegerlein, Christian

AU - Wunderlich, Silke

AU - Möhlenbruch, Markus A

AU - Radbruch, Alexander

AU - Gralla, Jan

AU - Fiehler, Jens

AU - Maus, Volker

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND AND PURPOSE: Acute ischemic stroke caused by primary multivessel occlusions (pMVO) is a rare but devastating disease. Whether multi-target mechanical thrombectomy for pMVO is beneficial remains unknown.METHODS: Multicenter retrospective review of patients treated with multi-target mechanical thrombectomy. The following pMVO sites were included: basilar artery, internal carotid artery, and middle cerebral artery (M1 and M2). Baseline characteristics were reported together with interventional technique, technical efficacy, and safety parameters. Clinical outcomes were evaluated applying the National Institutes of Health Stroke Scale and modified Rankin Scale. A systematic literature review was performed to summarize previous reports on pMVO mechanical thrombectomy.RESULTS: Of 6081 patients screened, 21 patients met the inclusion criteria (0.35% [95% CI, 0.23%-0.53%]). In 70% (14/20) a cardioembolic cause was reported. A successful reperfusion of Thrombolysis in Cerebral Infarction scale score ≥2b was achieved in 95.2% (20/21) for the first and 76.1% (16/21) for the second target vessel. In those who survived the acute hospital stay (n=10/21), median admission National Institutes of Health Stroke Scale improved from 21 (interquartile range, 13-27) to 8 (interquartile range, 2-20) at discharge (P=0.006). Mortality was 60% (12/20) at 90 days and only 20% (4/20) of patients reached modified Rankin Scale score ≤2. Acceptable outcomes were almost exclusively observed in pMVO patients presenting with at least one M2 occlusion.CONCLUSIONS: Multi-target mechanical thrombectomy for pMVOs is rarely performed; however, the procedure appears to be feasible and safe with high reperfusion rates for both occlusion sites. More than half of all treated patients deceased early and favorable outcomes may only be expected for pMVO patients including at least one M2 occlusion.

AB - BACKGROUND AND PURPOSE: Acute ischemic stroke caused by primary multivessel occlusions (pMVO) is a rare but devastating disease. Whether multi-target mechanical thrombectomy for pMVO is beneficial remains unknown.METHODS: Multicenter retrospective review of patients treated with multi-target mechanical thrombectomy. The following pMVO sites were included: basilar artery, internal carotid artery, and middle cerebral artery (M1 and M2). Baseline characteristics were reported together with interventional technique, technical efficacy, and safety parameters. Clinical outcomes were evaluated applying the National Institutes of Health Stroke Scale and modified Rankin Scale. A systematic literature review was performed to summarize previous reports on pMVO mechanical thrombectomy.RESULTS: Of 6081 patients screened, 21 patients met the inclusion criteria (0.35% [95% CI, 0.23%-0.53%]). In 70% (14/20) a cardioembolic cause was reported. A successful reperfusion of Thrombolysis in Cerebral Infarction scale score ≥2b was achieved in 95.2% (20/21) for the first and 76.1% (16/21) for the second target vessel. In those who survived the acute hospital stay (n=10/21), median admission National Institutes of Health Stroke Scale improved from 21 (interquartile range, 13-27) to 8 (interquartile range, 2-20) at discharge (P=0.006). Mortality was 60% (12/20) at 90 days and only 20% (4/20) of patients reached modified Rankin Scale score ≤2. Acceptable outcomes were almost exclusively observed in pMVO patients presenting with at least one M2 occlusion.CONCLUSIONS: Multi-target mechanical thrombectomy for pMVOs is rarely performed; however, the procedure appears to be feasible and safe with high reperfusion rates for both occlusion sites. More than half of all treated patients deceased early and favorable outcomes may only be expected for pMVO patients including at least one M2 occlusion.

U2 - 10.1161/STROKEAHA.120.029629

DO - 10.1161/STROKEAHA.120.029629

M3 - SCORING: Journal article

C2 - 32654632

VL - 51

SP - e232-e237

JO - STROKE

JF - STROKE

SN - 0039-2499

IS - 9

ER -