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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, Vol. 14, No. 9, 09.2022, p. 858-862.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Styczen, H, Maus, V, Goertz, L, Köhrmann, M, Kleinschnitz, C, Fischer, S, Möhlenbruch, M, Mühlen, I, Kallmünzer, B, Dorn, F, Lakghomi, A, Gawlitza, M, Kaiser, D, Klisch, J, Lobsien, D, Rohde, S, Ellrichmann, G, Behme, D, Thormann, M, Flottmann, F, Winkelmeier, L, Gizewski, ER, Mayer-Suess, L, Boeckh-Behrens, T, Riederer, I, Klingebiel, R, Berger, B, Schlunz-Hendann, M, Grieb, D, Khanafer, A, du Mesnil de Rochemont, R, Arendt, C, Altenbernd, J, Schlump, J-U, Ringelstein, A, Sanio, VJM, Loehr, C, Dahlke, AM, Brockmann, C, Reder, S, Sure, U, Li, Y, Mühl-Benninghaus, R, Rodt, T, Kallenberg, K, Durutya, A, Elsharkawy, M, Stracke, P, Schumann, MG, Bock, A, Nikoubashman, O, Wiesmann, M, Henkes, H, Mosimann, PJ, Chapot, R, Forsting, M & Deuschl, C 2022, 'Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases', J NEUROINTERV SURG, vol. 14, no. 9, pp. 858-862. https://doi.org/10.1136/neurintsurg-2022-018723

APA

Styczen, H., Maus, V., Goertz, L., Köhrmann, M., Kleinschnitz, C., Fischer, S., Möhlenbruch, M., Mühlen, I., Kallmünzer, B., Dorn, F., Lakghomi, A., Gawlitza, M., Kaiser, D., Klisch, J., Lobsien, D., Rohde, S., Ellrichmann, G., Behme, D., Thormann, M., ... Deuschl, C. (2022). Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases. J NEUROINTERV SURG, 14(9), 858-862. https://doi.org/10.1136/neurintsurg-2022-018723

Vancouver

Styczen H, Maus V, Goertz L, Köhrmann M, Kleinschnitz C, Fischer S et al. Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases. J NEUROINTERV SURG. 2022 Sep;14(9):858-862. https://doi.org/10.1136/neurintsurg-2022-018723

Bibtex

@article{5478ab6c53904f24bd1a082d6600faa1,
title = "Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases",
abstract = "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.",
author = "Hanna Styczen and Volker Maus and Lukas Goertz and Martin K{\"o}hrmann and Christoph Kleinschnitz and Sebastian Fischer and Markus M{\"o}hlenbruch and Iris M{\"u}hlen and Bernd Kallm{\"u}nzer and Franziska Dorn and Asadeh Lakghomi and Matthias Gawlitza and Daniel Kaiser and Joachim Klisch and Donald Lobsien and Stefan Rohde and Gisa Ellrichmann and Daniel Behme and Maximilian Thormann and Fabian Flottmann and Laurens Winkelmeier and Gizewski, {Elke R} and Lukas Mayer-Suess and Tobias Boeckh-Behrens and Isabelle Riederer and Randolf Klingebiel and Bj{\"o}rn Berger and Martin Schlunz-Hendann and Dominik Grieb and Ali Khanafer and {du Mesnil de Rochemont}, Richard and Christophe Arendt and Jens Altenbernd and Jan-Ulrich Schlump and Adrian Ringelstein and Sanio, {Vivian Jean Marcel} and Christian Loehr and Dahlke, {Agnes Maria} and Carolin Brockmann and Sebastian Reder and Ulrich Sure and Yan Li and Ruben M{\"u}hl-Benninghaus and Thomas Rodt and Kai Kallenberg and Alexandru Durutya and Mohamed Elsharkawy and Paul Stracke and Schumann, {Mathias Gerhard} and Alexander Bock and Omid Nikoubashman and Martin Wiesmann and Hans Henkes and Mosimann, {Pascal J} and Ren{\'e} Chapot and Michael Forsting and Cornelius Deuschl",
note = "{\textcopyright} Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2022",
month = sep,
doi = "10.1136/neurintsurg-2022-018723",
language = "English",
volume = "14",
pages = "858--862",
journal = "J NEUROINTERV SURG",
issn = "1759-8478",
publisher = "BMJ PUBLISHING GROUP",
number = "9",

}

RIS

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 -