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Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice

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Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice. / Kniep, Helge; Meyer, Lukas; Broocks, Gabriel; Bechstein, Matthias; Guerreiro, Helena; Winkelmeier, Laurens; Brekenfeld, Caspar; Flottmann, Fabian; Deb-Chatterji, Milani; Alegiani, Anna; Hanning, Uta; Thomalla, Götz; Fiehler, Jens; Gellißen, Susanne; German Stroke Registry – Endovascular Treatment (GSR – ET).

In: SCI REP-UK, Vol. 13, No. 1, 31.10.2023, p. 18740.

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

Harvard

Kniep, H, Meyer, L, Broocks, G, Bechstein, M, Guerreiro, H, Winkelmeier, L, Brekenfeld, C, Flottmann, F, Deb-Chatterji, M, Alegiani, A, Hanning, U, Thomalla, G, Fiehler, J, Gellißen, S & German Stroke Registry – Endovascular Treatment (GSR – ET) 2023, 'Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice', SCI REP-UK, vol. 13, no. 1, pp. 18740. https://doi.org/10.1038/s41598-023-45232-x

APA

Kniep, H., Meyer, L., Broocks, G., Bechstein, M., Guerreiro, H., Winkelmeier, L., Brekenfeld, C., Flottmann, F., Deb-Chatterji, M., Alegiani, A., Hanning, U., Thomalla, G., Fiehler, J., Gellißen, S., & German Stroke Registry – Endovascular Treatment (GSR – ET) (2023). Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice. SCI REP-UK, 13(1), 18740. https://doi.org/10.1038/s41598-023-45232-x

Vancouver

Kniep H, Meyer L, Broocks G, Bechstein M, Guerreiro H, Winkelmeier L et al. Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice. SCI REP-UK. 2023 Oct 31;13(1):18740. https://doi.org/10.1038/s41598-023-45232-x

Bibtex

@article{91e353d3f82a4c22bc475405c028919f,
title = "Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice",
abstract = "Mechanical thrombectomy (MT) for acute ischemic stroke with medium vessel occlusions is still a matter of debate. We sought to identify factors associated with clinical outcome after MT for M2-occlusions based on data from the German Stroke Registry-Endovascular Treatment (GSR-ET). All patients prospectively enrolled in the GSR-ET from 05/2015 to 12/2021 were analyzed (NCT03356392). Inclusion criteria were primary M2-occlusions and availability of relevant clinical data. Factors associated with excellent/good outcome (modified Rankin scale mRS 0-1/0-2), poor outcome/death (mRS 5-6) and mRS-increase pre-stroke to day 90 were determined in multivariable logistic regression. 1348 patients were included. 1128(84%) had successful recanalization, 595(44%) achieved good outcome, 402 (30%) had poor outcome. Successful recanalization (odds ratio [OR] 4.27 [95% confidence interval 3.12-5.91], p < 0.001), higher Alberta stroke program early CT score (OR 1.25 [1.18-1.32], p < 0.001) and i.v. thrombolysis (OR 1.28 [1.07-1.54], p < 0.01) increased probability of good outcome, while age (OR 0.95 [0.94-0.95], p < 0.001), higher pre-stroke-mRS (OR 0.36 [0.31-0.40], p < 0.001), higher baseline NIHSS (OR 0.89 [0.88-0.91], p < 0.001), diabetes (OR 0.52 [0.42-0.64], p < 0.001), higher number of passes (OR 0.75 [0.70-0.80], p < 0.001) and intracranial hemorrhage (OR 0.26 [0.14-0.46], p < 0.001) decreased the probability of good outcome. Additional predictors of mRS-increase pre-stroke to 90d were dissections, perforations (OR 1.59 [1.11-2.29], p < 0.05) and clot migration, embolization (OR 1.67 [1.21-2.30], p < 0.01). Corresponding to large-vessel-occlusions, younger age, low pre-stroke-mRS, low severity of acute clinical disability, i.v. thrombolysis and successful recanalization were associated with good outcome while diabetes and higher number of passes decreased probability of good outcome after MT in M2 occlusions. Treatment related complications increased probability of mRS increase pre-stroke to 90d.",
keywords = "Humans, Brain Ischemia/complications, Ischemic Stroke/complications, Treatment Outcome, Retrospective Studies, Stroke, Thrombectomy/adverse effects, Endovascular Procedures/adverse effects, Diabetes Mellitus",
author = "Helge Kniep and Lukas Meyer and Gabriel Broocks and Matthias Bechstein and Helena Guerreiro and Laurens Winkelmeier and Caspar Brekenfeld and Fabian Flottmann and Milani Deb-Chatterji and Anna Alegiani and Uta Hanning and G{\"o}tz Thomalla and Jens Fiehler and Susanne Gelli{\ss}en and {German Stroke Registry – Endovascular Treatment (GSR – ET)}",
note = "{\textcopyright} 2023. The Author(s).",
year = "2023",
month = oct,
day = "31",
doi = "10.1038/s41598-023-45232-x",
language = "English",
volume = "13",
pages = "18740",
journal = "SCI REP-UK",
issn = "2045-2322",
publisher = "NATURE PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Predictors of functional outcome after thrombectomy for M2 occlusions: a large scale experience from clinical practice

AU - Kniep, Helge

AU - Meyer, Lukas

AU - Broocks, Gabriel

AU - Bechstein, Matthias

AU - Guerreiro, Helena

AU - Winkelmeier, Laurens

AU - Brekenfeld, Caspar

AU - Flottmann, Fabian

AU - Deb-Chatterji, Milani

AU - Alegiani, Anna

AU - Hanning, Uta

AU - Thomalla, Götz

AU - Fiehler, Jens

AU - Gellißen, Susanne

AU - German Stroke Registry – Endovascular Treatment (GSR – ET)

N1 - © 2023. The Author(s).

PY - 2023/10/31

Y1 - 2023/10/31

N2 - Mechanical thrombectomy (MT) for acute ischemic stroke with medium vessel occlusions is still a matter of debate. We sought to identify factors associated with clinical outcome after MT for M2-occlusions based on data from the German Stroke Registry-Endovascular Treatment (GSR-ET). All patients prospectively enrolled in the GSR-ET from 05/2015 to 12/2021 were analyzed (NCT03356392). Inclusion criteria were primary M2-occlusions and availability of relevant clinical data. Factors associated with excellent/good outcome (modified Rankin scale mRS 0-1/0-2), poor outcome/death (mRS 5-6) and mRS-increase pre-stroke to day 90 were determined in multivariable logistic regression. 1348 patients were included. 1128(84%) had successful recanalization, 595(44%) achieved good outcome, 402 (30%) had poor outcome. Successful recanalization (odds ratio [OR] 4.27 [95% confidence interval 3.12-5.91], p < 0.001), higher Alberta stroke program early CT score (OR 1.25 [1.18-1.32], p < 0.001) and i.v. thrombolysis (OR 1.28 [1.07-1.54], p < 0.01) increased probability of good outcome, while age (OR 0.95 [0.94-0.95], p < 0.001), higher pre-stroke-mRS (OR 0.36 [0.31-0.40], p < 0.001), higher baseline NIHSS (OR 0.89 [0.88-0.91], p < 0.001), diabetes (OR 0.52 [0.42-0.64], p < 0.001), higher number of passes (OR 0.75 [0.70-0.80], p < 0.001) and intracranial hemorrhage (OR 0.26 [0.14-0.46], p < 0.001) decreased the probability of good outcome. Additional predictors of mRS-increase pre-stroke to 90d were dissections, perforations (OR 1.59 [1.11-2.29], p < 0.05) and clot migration, embolization (OR 1.67 [1.21-2.30], p < 0.01). Corresponding to large-vessel-occlusions, younger age, low pre-stroke-mRS, low severity of acute clinical disability, i.v. thrombolysis and successful recanalization were associated with good outcome while diabetes and higher number of passes decreased probability of good outcome after MT in M2 occlusions. Treatment related complications increased probability of mRS increase pre-stroke to 90d.

AB - Mechanical thrombectomy (MT) for acute ischemic stroke with medium vessel occlusions is still a matter of debate. We sought to identify factors associated with clinical outcome after MT for M2-occlusions based on data from the German Stroke Registry-Endovascular Treatment (GSR-ET). All patients prospectively enrolled in the GSR-ET from 05/2015 to 12/2021 were analyzed (NCT03356392). Inclusion criteria were primary M2-occlusions and availability of relevant clinical data. Factors associated with excellent/good outcome (modified Rankin scale mRS 0-1/0-2), poor outcome/death (mRS 5-6) and mRS-increase pre-stroke to day 90 were determined in multivariable logistic regression. 1348 patients were included. 1128(84%) had successful recanalization, 595(44%) achieved good outcome, 402 (30%) had poor outcome. Successful recanalization (odds ratio [OR] 4.27 [95% confidence interval 3.12-5.91], p < 0.001), higher Alberta stroke program early CT score (OR 1.25 [1.18-1.32], p < 0.001) and i.v. thrombolysis (OR 1.28 [1.07-1.54], p < 0.01) increased probability of good outcome, while age (OR 0.95 [0.94-0.95], p < 0.001), higher pre-stroke-mRS (OR 0.36 [0.31-0.40], p < 0.001), higher baseline NIHSS (OR 0.89 [0.88-0.91], p < 0.001), diabetes (OR 0.52 [0.42-0.64], p < 0.001), higher number of passes (OR 0.75 [0.70-0.80], p < 0.001) and intracranial hemorrhage (OR 0.26 [0.14-0.46], p < 0.001) decreased the probability of good outcome. Additional predictors of mRS-increase pre-stroke to 90d were dissections, perforations (OR 1.59 [1.11-2.29], p < 0.05) and clot migration, embolization (OR 1.67 [1.21-2.30], p < 0.01). Corresponding to large-vessel-occlusions, younger age, low pre-stroke-mRS, low severity of acute clinical disability, i.v. thrombolysis and successful recanalization were associated with good outcome while diabetes and higher number of passes decreased probability of good outcome after MT in M2 occlusions. Treatment related complications increased probability of mRS increase pre-stroke to 90d.

KW - Humans

KW - Brain Ischemia/complications

KW - Ischemic Stroke/complications

KW - Treatment Outcome

KW - Retrospective Studies

KW - Stroke

KW - Thrombectomy/adverse effects

KW - Endovascular Procedures/adverse effects

KW - Diabetes Mellitus

U2 - 10.1038/s41598-023-45232-x

DO - 10.1038/s41598-023-45232-x

M3 - SCORING: Journal article

C2 - 37907482

VL - 13

SP - 18740

JO - SCI REP-UK

JF - SCI REP-UK

SN - 2045-2322

IS - 1

ER -