Abstract WMP8: Clinical Outcomes After Mechanical Thrombectomy in Acute Ischemic Stroke Patients Aged 65 Years and over: a Subgroup Analysis of the Stratis Registry

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Nils H Mueller-Kronast ◽  
Reza Jahan ◽  
David S Liebeskind ◽  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Subgroup Analysis ◽  
Mechanical Thrombectomy ◽  
Stroke Patients

Abstract WP372: Hydration Status and Clinical Outcomes in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Mona N Bahouth ◽  
Rebecca Gottesman
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Blood Urea Nitrogen ◽  
Mechanical Thrombectomy ◽  
Large Vessel ◽  
Hydration Status ◽  
Creatinine Ratio ◽  
Stroke Patients ◽  
Anterior Circulation

Introduction: Impaired hydration measured by elevated blood urea nitrogen (BUN) to creatinine ratio has been associated with worsened outcome after acute ischemic stroke. Whether hydration status is relevant for patients with acute ischemic stroke treated with mechanical thrombectomy remains unknown. Materials and Methods: We conducted a retrospective review of consecutive acute ischemic stroke patients who underwent endovascular procedures for anterior circulation large artery occlusion at Johns Hopkins Comprehensive Stroke Centers between 2012 and 2017. A volume contracted state (VCS), was determined based on surrogate lab markers and defined as blood urea nitrogen (BUN) to creatinine ratio greater than 15. Endpoints were achievement of successful revascularization (TICI 2b or 3), early re-occlusion, and short term clinical outcomes including development of early neurological worsening and functional outcome at 3 months. Results: Of the 158 patients who underwent an endovascular procedure, 102 patients had a final diagnosis of anterior circulation large vessel occlusion and met the inclusion criteria for analysis. Volume contracted state was present in 62/102 (61%) of patients. Successful revascularization was achieved in 75/102 (74%) of the cohort. There was no relationship between VCS and successful revascularization, but there was a 1.13 increased adjusted odds (95% CI 1.01, 1.27) of re-occlusion within 24 hours for every point higher BUN/creatinine ratio in the subset of patients who underwent radiological testing for pre-procedure planning (n=57). There was no relationship between VCS and clinical outcomes including early neurological worsening and 3 month outcome. Conclusions: Patients with VCS and large vessel anterior circulation stroke may have a higher odds of early re-occlusion after mechanical thrombectomy than their non-VCS counterparts, but no differences in successful revascularization nor clinical outcomes were present in this cohort. These results may suggest an opportunity for the exploration of pre-procedure hydration to improve outcomes.

The role of CT texture analysis in predicting the clinical outcomes of acute ischemic stroke patients undergoing mechanical thrombectomy

2021 ◽  
Author(s):  
Orkun Sarioglu ◽  
Fatma Ceren Sarioglu ◽  
Ahmet Ergin Capar ◽  
Demet Funda Bas Sokmez ◽  
Pelin Topkaya ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Texture Analysis ◽  
Clinical Outcomes ◽  
Mechanical Thrombectomy ◽  
Stroke Patients ◽  
Ct Texture Analysis

scholarly journals Efficacy of Mechanical Thrombectomy using Penumbra ACETM Aspiration Catheter Compared to Stent Retriever SolitaireTM FR in Patients with Acute Ischemic Stroke

2021 ◽  
Vol 11 (4) ◽  
pp. 504
Author(s):  
Dalibor Sila ◽  
Markus Lenski ◽  
Maria Vojtková ◽  
Mustafa Elgharbawy ◽  
František Charvát ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Mechanical Thrombectomy ◽  
Binary Logistic Regression ◽  
Stent Retriever ◽  
Good Clinical Outcome ◽  
Significant Difference ◽  
Aspiration Technique

Background: Mechanical thrombectomy is the standard therapy in patients with acute ischemic stroke (AIS). The primary aim of our study was to compare the procedural efficacy of the direct aspiration technique, using Penumbra ACETM aspiration catheter, and the stent retriever technique, with a SolitaireTM FR stent. Secondarily, we investigated treatment-dependent and treatment-independent factors that predict a good clinical outcome. Methods: We analyzed our series of mechanical thrombectomies using a SolitaireTM FR stent and a Penumbra ACETM catheter. The clinical and radiographic data of 76 patients were retrospectively reviewed. Using binary logistic regression, we looked for the predictors of a good clinical outcome. Results: In the Penumbra ACETM group we achieved significantly higher rates of complete vessel recanalization with lower device passage counts, shorter recanalization times, shorter procedure times and shorter fluoroscopy times (p < 0.001) compared to the SolitaireTM FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, p = 0.756). Predictors of a good clinical outcome were lower initial NIHSS scores, pial arterial collateralization on admission head CT angiography scan, shorter recanalization times and device passage counts. Conclusions: The aspiration technique using Penumbra ACETM catheter is comparable to the stent retriever technique with SolitaireTM FR regarding clinical outcomes.

Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease

2021 ◽  
pp. 159101992110394
Author(s):  
Ameer E Hassan ◽  
Victor M Ringheanu ◽  
Laurie Preston ◽  
Wondwossen G Tekle ◽  
Adnan I Qureshi
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Intracranial Stenting ◽  
Intracranial Atherosclerotic Disease

Objective To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting. Methods Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared. Results There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group ( p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization ( p = 0.758), or good modified Rankin Scale scores ( p = 0.806). Conclusion Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.

scholarly journals Prognostic Significance of Pulse Pressure Variability During Mechanical Thrombectomy in Acute Ischemic Stroke Patients

2018 ◽  
Vol 7 (18) ◽  
Author(s):  
Benjamin Maïer ◽  
Guillaume Turc ◽  
Guillaume Taylor ◽  
Raphaël Blanc ◽  
Michael Obadia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Pulse Pressure ◽  
Mechanical Thrombectomy ◽  
Prognostic Significance ◽  
Stroke Patients

116 Effect of Annual Hospital Procedure Volume on Outcomes After Mechanical Thrombectomy in Acute Ischemic Stroke Patients

Neurosurgery ◽  
2016 ◽  
Vol 63 ◽  
pp. 149 ◽  
Author(s):  
Vishal B. Jani ◽  
Chiu Yuen To ◽  
Achint Patel ◽  
Prashant S. Kelkar ◽  
Boyd Richards ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Stroke Patients ◽  
Procedure Volume

scholarly journals CLINICAL OUTCOMES OF ACUTE ISCHEMIC STROKE PATIENTS STRATIFIED BY CARDIAC TROPONIN-I: A RETROSPECTIVE ANALYSIS

2017 ◽  
Vol 69 (11) ◽  
pp. 140
Author(s):  
Dylan Stanger ◽  
Siu Him Chan ◽  
Samuel Yip ◽  
Belinda Rodis ◽  
Andrew Starovoytov ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Stroke Patients

scholarly journals Anestezijos metodo reikšmė pacientų, sergančių ūminiu išeminiu insultu ir gydytų mechanine trombektomija, ankstyvai neurologinei būklei Relevance of anaesthesia type on early neurological outcome in acute ischemic stroke patients undergoing mechanical thrombectomy

2019 ◽  
Vol 22 (78) ◽  
pp. 325-329
Author(s):  
L. Šalaševičius ◽  
A. Vilionskis
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Outcome ◽  
Mechanical Thrombectomy ◽  
Stroke Patients

Įvadas. Sąmonės sedacija (SS) ir bendroji endotrachėjinė anestezija (BETA) – anestezijos metodai, taikomi mechaninės trombektomijos (MTE) metu. Tikslių rekomendacijų dėl anestezijos metodo pasirinkimo MTE metu nėra. Retrospektyviniai tyrimai teigia, kad BETA yra susijusi su blogesnėmis pacientų išeitimis, tačiau naujuose klinikiniuose tyrimuose tokio skirtumo nestebima. Darbo tikslas buvo nustatyti anestezijos metodo įtaką mechaninės trombektomijos efektyvumui ir saugumui ligoniams, patyrusiems ūminį išeminį insultą. Tiriamieji ir tyrimo metodai. Į tyrimą įtraukti dviejuose Vilniaus centruose gydyti ūminį išeminį insultą patyrę ligoniai, kuriems buvo atlikta MTE. Ligoniai suskirstyti į 2 grupes pagal taikytą anestezijos metodą: bendroji endotrachėjinė anestezija (BETA) ir sąmonės sedacija (SS). Abiejose grupėse vertinti demografiniai, klinikiniai ir logistiniai rodikliai. Pirminiu vertinimo kriterijumi pasirinkta gera baigtis po 24 valandų. MTE saugumas vertintas pagal 7 parų mirštamumą ir simptominių intrasmegeninių kraujosruvų (sISK) dažnį. Rezultatai. Į tyrimą įtraukta 248 pacientai. 105 pacientams (42,3 %) taikyta BETA ir 143 (57,7 %) – SS. Pagal pradines charakteristikas abi grupės statistiškai nesiskyrė, išskyrus prieširdžių virpėjimo dažnį (55,9 % – SS vs 37,1 % – BETA grupėje, p = 0,003) ir intraveninės trombolizės taikymą iki MTE (66,4 % – SS grupėje ir 46,7 % – BETA grupėje, p = 0,003). Gera baigtis po 24 val. nustatyta 51,4 % (n = 54) ligonių – BETA grupėje ir 58,7 % (n = 84) ligonių – SS grupėje (p = 0,252). 7 parų mirštamumo sISK dažnis abiejose grupėse statistiškai reikšmingai nesiskyrė. Regresinė analizė parodė, kad geros baigties nepriklausomi prognoziniai veiksniai yra laikas nuo atvykimo į stacionarą iki rekanalizacijos ir sėkminga rekanalizacija. Išvados. Anestezijos tipas nėra reikšmingas mechaninės trombektomijos efektyvumo ir saugumo veiksnys ankstyvai pacientų baigčiai. Siekiant tiksliau įvertinti anestezijos reikšmę mechaninės trombektomijos baigčiai ir nustatyti procedūros baigties prognozinius veiksnius, reikalingi papildomi atsitiktinės atrankos tyrimai.

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