Incidence and outcome of perforations during medium vessel occlusion compared with large vessel occlusion thrombectomy

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Victor Schulze-Zachau - , Universitätsspital Basel (Autor:in)
  • Alex Brehm - , Universitätsspital Basel (Autor:in)
  • Nikolaos Ntoulias - , Universitätsspital Basel (Autor:in)
  • Nadja Krug - , Universitätsspital Basel (Autor:in)
  • Ioannis Tsogkas - , Universitätsspital Basel (Autor:in)
  • Kristine Ann Blackham - , Universitätsspital Basel (Autor:in)
  • Markus A Möhlenbruch - , Universitätsklinikum Heidelberg (Autor:in)
  • Jessica Jesser - , Universitätsklinikum Heidelberg (Autor:in)
  • Amedeo Cervo - , Ospedale Niguarda Ca'Granda (Autor:in)
  • Kornelia Kreiser - , Radiology and Neuroradiology Clinic (Autor:in)
  • Katharina Althaus - , Universitätsklinikum Ulm (Autor:in)
  • Errikos Maslias - , Centre Hospitalier Universitaire Vaudois (Autor:in)
  • Patrik Michel - , Centre Hospitalier Universitaire Vaudois (Autor:in)
  • Guillaume Saliou - , Université de Lausanne (Autor:in)
  • Christoph Riegler - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Christian H Nolte - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Ilko Maier - , Universitätsmedizin Göttingen (Autor:in)
  • Ala Jamous - , Universitätsmedizin Göttingen (Autor:in)
  • Riitta Rautio - , Turun Yliopistollinen Keskussairaala (Autor:in)
  • Pauli Ylikotila - , Turun Yliopistollinen Keskussairaala (Autor:in)
  • Kyle M Fargen - , Wake Forest School of Medicine (Autor:in)
  • Stacey Q Wolfe - , Wake Forest School of Medicine (Autor:in)
  • Davide Castellano - , Ospedale San Giovanni Bosco (Autor:in)
  • Andrea Boghi - , Ospedale San Giovanni Bosco (Autor:in)
  • Daniel P O Kaiser - , Institut und Poliklinik für Diagnostische und Interventionelle Neuroradiologie (Autor:in)
  • Ani Cuberi - , Institut und Poliklinik für diagnostische und interventionelle Radiologie (Autor:in)
  • Jan S Kirschke - , Klinikum Rechts der Isar (MRI TUM) (Autor:in)
  • Julian Schwarting - , Klinikum Rechts der Isar (MRI TUM) (Autor:in)
  • Nicola Limbucci - , Azienda Ospedaliera Careggi (Autor:in)
  • Leonardo Renieri - , Azienda Ospedaliera Careggi (Autor:in)
  • Sami Al Kasab - , Medical University of South Carolina (Autor:in)
  • Alejandro M Spiotta - , Medical University of South Carolina (Autor:in)
  • Isabel Fragata - , Centro Hospitalar Universitario de Lisboa Central (CHLC) (Autor:in)
  • Tania Rodriquez-Ares - , Centro Hospitalar Universitario de Lisboa Central (CHLC) (Autor:in)
  • Christoph Johannes Maurer - , Universitätsklinikum Augsburg (Autor:in)
  • Ansgar Berlis - , Universitätsklinikum Augsburg (Autor:in)
  • Manuel Moreu - , Hospital Clinico Universitario San Carlos (Autor:in)
  • Alfonso López-Frías - , Hospital Clinico Universitario San Carlos (Autor:in)
  • Carlos Pérez-García - , Hospital Clinico Universitario San Carlos (Autor:in)
  • Christian Commodaro - , Istituto di Neuroscienze Cliniche della Svizzera Italiana (Autor:in)
  • Marco Pileggi - , Istituto di Neuroscienze Cliniche della Svizzera Italiana (Autor:in)
  • Justin Mascitelli - , University of Texas Health Science Center at San Antonio (Autor:in)
  • Flavio Giordano - , Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli (Autor:in)
  • Walter Casagrande - , Hospital General de Agudos Juan Fernandez (Autor:in)
  • Cynthia P Purves - , Hospital General de Agudos Juan Fernandez (Autor:in)
  • Maxim Bester - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Fabian Flottmann - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Peter T Kan - , University of Texas Medical Branch at Galveston (Autor:in)
  • Gautam Edhayan - , University of Texas Medical Branch at Galveston (Autor:in)
  • Jeremy Hofmeister - , Hôpitaux universitaires de Genève (Autor:in)
  • Paolo Machi - , Hôpitaux universitaires de Genève (Autor:in)
  • Marius Kaschner - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Daniel Weiss - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Mira Katan - , Universitätsspital Basel (Autor:in)
  • Urs Fischer - , Universitätsspital Basel (Autor:in)
  • Marios-Nikos Psychogios - , Universitätsspital Basel (Autor:in)

Abstract

BACKGROUND: Vessel perforation during thrombectomy is a severe complication and is hypothesized to be more frequent during medium vessel occlusion (MeVO) thrombectomy. The aim of this study was to compare the incidence and outcome of patients with perforation during MeVO and large vessel occlusion (LVO) thrombectomy and to report on the procedural steps that led to perforation.

METHODS: In this multicenter retrospective cohort study, data of consecutive patients with vessel perforation during thrombectomy between January 1, 2015 and September 30, 2022 were collected. The primary outcomes were independent functional outcome (ie, modified Rankin Scale 0-2) and all-cause mortality at 90 days. Binomial test, chi-squared test and t-test for unpaired samples were used for statistical analysis.

RESULTS: During 25 769 thrombectomies (5124 MeVO, 20 645 LVO) in 25 stroke centers, perforation occurred in 335 patients (1.3%; mean age 72 years, 62% female). Perforation occurred more often in MeVO thrombectomy (2.4%) than in LVO thrombectomy (1.0%, p<0.001). More MeVO than LVO patients with perforation achieved functional independence at 3 months (25.7% vs 10.9%, p=0.001). All-cause mortality did not differ between groups (overall 51.6%). Navigation beyond the occlusion and retraction of stent retriever/aspiration catheter were the two most common procedural steps that led to perforation.

CONCLUSIONS: In our cohort, perforation was approximately twice as frequent in MeVO than in LVO thrombectomy. Efforts to optimize the procedure may focus on navigation beyond the occlusion site and retraction of stent retriever/aspiration catheter. Further research is necessary in order to identify thrombectomy candidates at high risk of intraprocedural perforation and to provide data on the effectiveness of endovascular countermeasures.

Details

OriginalspracheEnglisch
Seiten (von - bis)775-780
Seitenumfang6
Fachzeitschrift Journal of neuroInterventional surgery : JNIS
Jahrgang16
Ausgabenummer8
PublikationsstatusElektronische Veröffentlichung vor Drucklegung - 31 Juli 2023
Peer-Review-StatusJa

Externe IDs

ORCID /0000-0001-5258-0025/work/146644954
Scopus 85177883102
Mendeley 2666b6d2-2518-32fe-8bb4-dfe00d7207cb

Schlagworte