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Neuroradiology

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01-06-2014 | Interventional Neuroradiology

Complications of mechanical thrombectomy for acute ischemic stroke—a retrospective single-center study of 176 consecutive cases

Authors: Daniel Behme, Ludger Gondecki, Sarah Fiethen, Annika Kowoll, Anastasios Mpotsaris, Werner Weber

Published in: Neuroradiology | Issue 6/2014

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

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Title: Complications of mechanical thrombectomy for acute ischemic stroke—a retrospective single-center study of 176 consecutive cases
Authors: Daniel Behme
Ludger Gondecki
Sarah Fiethen
Annika Kowoll
Anastasios Mpotsaris
Werner Weber
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 6/2014
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-014-1352-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Complications of mechanical thrombectomy for acute ischemic stroke—a retrospective single-center study of 176 consecutive cases

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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