Behme, Daniel, Gondecki, Ludger, Fiethen, Sarah, Kowoll, Annika, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 and Weber, Werner ORCID: 0000-0001-9825-8074 (2014). Complications of mechanical thrombectomy for acute ischemic stroke-a retrospective single-center study of 176 consecutive cases. Neuroradiology, 56 (6). S. 467 - 477. NEW YORK: SPRINGER. ISSN 1432-1920

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Abstract

There is only very limited data about complications in mechanical thrombectomy for acute ischemic stroke. The purpose of this study was to evaluate the frequency and the clinical relevance of procedure-related complications in mechanical thrombectomy. We conducted a retrospective analysis of 176 consecutive acute ischemic stroke cases that were treated with mechanical thrombectomy. Primary outcome measures included the following: symptomatic intracranial hemorrhage (sICH), vessel dissection, emboli to new vascular territories, vasospasm, and stent dislocation/occlusion whenever appropriate. Secondary outcome measures included mTICI score, time from symptom onset to revascularization, and time from groin puncture to revascularization as well as the early clinical outcome at discharge. Complications occurred in 20/176 patients (11 %) comprising 23 adverse events at the following rates: sICH 8/176 (5 %), emboli to new vascular territories 4/176 (2 %); vessel dissection 3/176 (2 %); vasospasm of the access vessel 5/176 (3 %); stent dislocation in 1/42 (2 %); and stent occlusion in 2/42 (5 %). Two out of 20 (10 %) suffered from two or more procedure-related complications. There was a statistically significant correlation of complications with time from groin puncture to revascularization, unfavorable revascularization results, and unfavorable clinical outcome. Overall, the frequency of procedure-related complications lies within acceptable limits for an emergency procedure. The endovascular treatment does not seem to add significantly to the stroke patients' risk of sICH but implies an innate risk of stroke in an initially uninvolved territory. Furthermore, a prolonged endovascular procedure beyond an hour is correlated with higher complication rates, which underlines the importance of a swift and complete revascularization.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Behme, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gondecki, LudgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fiethen, SarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kowoll, AnnikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mpotsaris, AnastasiosUNSPECIFIEDorcid.org/0000-0002-1275-8164UNSPECIFIED
Weber, WernerUNSPECIFIEDorcid.org/0000-0001-9825-8074UNSPECIFIED
URN: urn:nbn:de:hbz:38-437614
DOI: 10.1007/s00234-014-1352-0
Journal or Publication Title: Neuroradiology
Volume: 56
Number: 6
Page Range: S. 467 - 477
Date: 2014
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-1920
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TISSUE-PLASMINOGEN-ACTIVATOR; ENDOVASCULAR TREATMENT; INTRAVENOUS THROMBOLYSIS; ARTERY OCCLUSIONS; CENTER EXPERIENCE; RANDOMIZED-TRIAL; STENT-RETRIEVER; SOLITAIRE FR; RECANALIZATION; REVASCULARIZATIONMultiple languages
Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/43761

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