Outcome of standard and high-risk patients with acute anterior circulation stroke after stent retriever thrombectomy.

Gratz, Pascal P.; Jung, Simon; Schroth, Gerhard; Gralla, Jan; Mordasini, Pasquale; Hsieh, Kety; Heldner, Mirjam Rachel; Mattle, Heinrich P.; Mono, Marie-Luise; Fischer, Urs; Arnold, Marcel; Zubler, Christoph (2014). Outcome of standard and high-risk patients with acute anterior circulation stroke after stent retriever thrombectomy. Stroke, 45(1), pp. 152-158. Lippincott Williams & Wilkins 10.1161/STROKEAHA.113.002591

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BACKGROUND AND PURPOSE Stent retrievers have become an important tool for the treatment of acute ischemic stroke. The aim of this study was to analyze outcome and complications in a large cohort of patients with stroke treated with the Solitaire stent retriever. The study also included patients who did not meet standard inclusion criteria for endovascular treatment: low or high baseline National Institutes of Health Stroke Scale score, ≥80 years of age, extensive ischemic signs in middle cerebral artery territory, and time from symptom onset to endovascular intervention>8 hours. METHODS Consecutive patients with acute anterior circulation stroke treated with the Solitaire FR were analyzed. Data on characteristics of endovascular interventions, complications, and clinical outcome were collected prospectively. Patients who met standard inclusion criteria were compared with those who did not. RESULTS A total of 227 patients were included. Mean age was 68.2±14.7 years, and median National Institutes of Health Stroke Scale score on admission was 16 (range, 2-36). Reperfusion was successful (thrombolysis in cerebral infarction, 2b-3) in 70.9%. Outcome was favorable (modified Rankin Scale, 0-2) in 57.7% of patients who met standard inclusion criteria and 30.3% of those who did not. The rates for symptomatic intracranial hemorrhage were 3.7% and 13.1%, for death 11.4% and 33.8%, and for symptomatic intraprocedural complications 2.5% and 4.8%, respectively. CONCLUSIONS Patients<80 years of age, without extensive pretreatment ischemic signs, and baseline National Institutes of Health Stroke Scale score≤30 had high rates of favorable outcome and low periprocedural complication rates after Solitaire thrombectomy. Successful reperfusion was also common in patients not fulfilling standard inclusion criteria, but worse clinical outcomes warrant further research with a special focus on optimal patient selection.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Jung, Simon; Schroth, Gerhard; Gralla, Jan; Mordasini, Pasquale; Hsieh, Kety Wha-Vei; Heldner, Mirjam Rachel; Mattle, Heinrich; Mono, Marie-Luise; Fischer, Urs; Arnold, Marcel and Zubler, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0039-2499

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

12 Jun 2014 07:57

Last Modified:

29 Dec 2017 10:01

Publisher DOI:

10.1161/STROKEAHA.113.002591

PubMed ID:

24262328

Additional Information:

Arnold und Zubler contribute equally

Uncontrolled Keywords:

stroke, thrombectomy

BORIS DOI:

10.7892/boris.48079

URI:

https://boris.unibe.ch/id/eprint/48079

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