Mechanical thrombectomy for acute ischemic stroke in COVID-19 patients: multicenter experience in 111 cases

被引：8

作者：

Styczen, Hanna ^{[1
]}

Maus, Volker ^{[2
]}

Goertz, Lukas ^{[3
]}

Koehrmann, Martin ^{[4
,5
]}

Kleinschnitz, Christoph ^{[4
,5
]}

Fischer, Sebastian ^{[2
]}

Moehlenbruch, Markus ^{[6
]}

Muehlen, Iris ^{[7
]}

Kallmuenzer, Bernd ^{[8
]}

Dorn, Franziska ^{[9
]}

Lakghomi, Asadeh ^{[9
]}

Gawlitza, Matthias ^{[10
]}

Kaiser, Daniel ^{[10
]}

Klisch, Joachim ^{[11
]}

Lobsien, Donald ^{[11
]}

Rohde, Stefan ^{[12
]}

Ellrichmann, Gisa ^{[13
]}

Behme, Daniel ^{[14
]}

Thormann, Maximilian ^{[15
]}

Flottmann, Fabian ^{[16
]}

Winkelmeier, Laurens ^{[16
]}

Gizewski, Elke R. ^{[17
]}

Mayer-Suess, Lukas ^{[18
]}

Boeckh-Behrens, Tobias ^{[19
]}

Riederer, Isabelle ^{[19
]}

Klingebiel, Randolf ^{[20
]}

Berger, Bjoern ^{[20
]}

Schlunz-Hendann, Martin ^{[21
]}

Grieb, Dominik ^{[21
]}

Khanafer, Ali ^{[22
]}

de Rochemont, Richard du Mesnil ^{[23
,24
]}

Arendt, Christophe ^{[23
,24
]}

Altenbernd, Jens ^{[25
]}

Schlump, Jan-Ulrich ^{[26
]}

Ringelstein, Adrian ^{[27
]}

Sanio, Vivian Jean Marcel ^{[27
]}

Loehr, Christian ^{[28
]}

Dahlke, Agnes Maria ^{[28
]}

Brockmann, Carolin ^{[29
]}

Reder, Sebastian ^{[29
]}

Sure, Ulrich ^{[30
]}

Li, Yan ^{[1
]}

Muehl-Benninghaus, Ruben ^{[31
]}

Rodt, Thomas ^{[31
]}

Kallenberg, Kai ^{[32
]}

Durutya, Alexandru ^{[32
]}

Elsharkawy, Mohamed ^{[33
]}

Stracke, Paul ^{[33
]}

Schumann, Mathias Gerhard ^{[34
]}

Bock, Alexander ^{[34
]}

机构：

[1] Univ Hosp Essen, Inst Diagnost & Intervent Radiol & Neuroradiol, D-45147 Essen, Germany

[2] Univ Med Ctr Langendreer, Dept Radiol Neuroradiol & Nucl Med, Bochum, Germany

[3] Univ Hosp Cologne, Dept Diagnost & Intervent Radiol, Cologne, Germany

[4] Univ Hosp Essen, Dept Neurol, Essen, Germany

[5] Univ Hosp Essen, Ctr Translat Neurosci & Behav Sci CTNBS, Essen, Germany

[6] Heidelberg Univ, Dept Neuroradiol, Heidelberg, Germany

[7] Univ Erlangen Nurnberg, Dept Neuroradiol, Erlangen, Germany

[8] Univ Erlangen Nurnberg, Dept Neurol, Erlangen, Germany

[9] Univ Hosp Bonn, Dept Neuroradiol, Bonn, Germany

[10] Univ Klinikum Carl Gustav Carus, Inst & Policlin Neuroradiol, Dresden, Sachsen, Germany

[11] Helios Gen Hosp Erfurt, Dept Diagnost & Intervent Radiol & Neuroradiol, Erfurt, Germany

[12] Klinikum Dortmund gGmbH, Dept Radiol & Neuroradiol, Dortmund, Germany

[13] Klinikum Dortmund gGmbH, Dept Neurol, Dortmund, Germany

[14] Univ Hosp Magdeburg, Dept Neuroradiol, Magdeburg, Germany

[15] Univ Hosp Magdeburg, Dept Radiol, Magdeburg, Germany

[16] Univ Hosp Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, Hamburg, Germany

[17] Med Univ Innsbruck, Dept Neuroradiol, Innsbruck, Austria

[18] Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria

[19] Tech Univ Munich, Dept Diagnost & Intervent Neuroradiol, Klinikum Rechts Isar, Munich, Germany

[20] Univ Hosp OWL, Dept Diagnost & Intervent Neuroradiol, Campus Bethel, Bielefeld, Germany

[21] Klinikum Duisburg Sana Kliniken, Dept Radiol & Neuroradiol, Duisburg, Germany

[22] Klinikum Stuttgart, Clin Neuroradiol, Stuttgart, Germany

[23] Univ Hosp Frankfurt, Inst Neuroradiol, Frankfurt, Germany

[24] Goethe Univ, Frankfurt, Germany

[25] Gemeinschaftskrankenhaus Herdecke, Dept Radiol & Neuroradiol, Herdecke, Germany

[26] Gemeinschaftskrankenhaus Herdecke, Dept Neuropediat, Herdecke, Germany

[27] Kliniken Maria Hilf, Dept Radiol & Neuroradiol, Monchengladbach, Germany

[28] Klinikum Vest, Dept Radiol & Neuroradiol, Recklinghausen, Germany

[29] Univ Med Ctr Mainz, Dept Neuroradiol, Mainz, Germany

[30] Univ Hosp Essen, Dept Neurosurg & Spine Surg, Essen, Germany

[31] Klinikum Lueneburg, Dept Radiol, Luneburg, Germany

[32] Klinikum Fulda, Dept Neuroradiol, Fulda, Germany

[33] Univ Hosp Muenster, Clin Radiol, Munster, Germany

[34] Vivantes Klinikum Neukoelln, Dept Neuroradiol, Berlin, Germany

[35] Univ Hosp Aachen, Dept Diagnost & Intervent Neuroradiol, Aachen, Germany

[36] Alfried Krupp Hosp Ruttenscheid, Dept Neuroradiol, Essen, Germany

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2022年 / 14卷 / 09期

关键词：

COVID-19; Infection; Stroke; Thrombectomy;

D O I：

10.1136/neurintsurg-2022-018723

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Background Data on the frequency and outcome of mechanical thrombectomy (MT) for large vessel occlusion (LVO) in patients with COVID-19 is limited. Addressing this subject, we report our multicenter experience. Methods A retrospective cohort study was performed of consecutive acute stroke patients with COVID-19 infection treated with MT at 26 tertiary care centers between January 2020 and November 2021. Baseline demographics, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at discharge and 90 days were noted. Results We identified 111 out of 11 365 (1%) patients with acute or subsided COVID-19 infection who underwent MT due to LVO. Cardioembolic events were the most common etiology for LVO (38.7%). Median baseline National Institutes of Health Stroke Scale score and Alberta Stroke Program Early CT Score were 16 (IQR 11.5-20) and 9 (IQR 7-10), respectively. Successful reperfusion (mTICI >= 2b) was achieved in 97/111 (87.4%) patients and 46/111 (41.4%) patients were reperfused completely. The procedure-related complication rate was 12.6% (14/111). Functional independence was achieved in 20/108 (18.5%) patients at discharge and 14/66 (21.2%) at 90 days follow-up. The in-hospital mortality rate was 30.6% (33/108). In the subgroup analysis, patients with severe acute COVID-19 infection requiring intubation had a mortality rate twice as high as patients with mild or moderate acute COVID-19 infection. Acute respiratory failure requiring ventilation and time interval from symptom onset to groin puncture were independent predictors for an unfavorable outcome in a logistic regression analysis. Conclusion Our study showed a poor clinical outcome and high mortality, especially in patients with severe acute COVID-19 infection undergoing MT due to LVO.

引用

页码：858 / +

页数：6

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