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

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Hanna Styczen - , Universität Duisburg-Essen (Autor:in)
  • Volker Maus - , Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH (Autor:in)
  • Lukas Goertz - , Universität zu Köln (Autor:in)
  • Martin Köhrmann - , Universität Duisburg-Essen (Autor:in)
  • Christoph Kleinschnitz - , Universität Duisburg-Essen (Autor:in)
  • Sebastian Fischer - , Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH (Autor:in)
  • Markus Möhlenbruch - , Universität Heidelberg (Autor:in)
  • Iris Mühlen - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Bernd Kallmünzer - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Franziska Dorn - , Universität Bonn (Autor:in)
  • Asadeh Lakghomi - , Universität Bonn (Autor:in)
  • Matthias Gawlitza - , Technische Universität Dresden (Autor:in)
  • Daniel Kaiser - , Institut und Poliklinik für Diagnostische und Interventionelle Neuroradiologie, Institute for Neuroradiology, Technische Universität Dresden (Autor:in)
  • Joachim Klisch - , Fresenius AG (Autor:in)
  • Donald Lobsien - , Fresenius AG (Autor:in)
  • Stefan Rohde - , Klinikum Dortmund gGmbH (Autor:in)
  • Gisa Ellrichmann - , Klinikum Dortmund gGmbH (Autor:in)
  • Daniel Behme - , Otto von Guericke University Magdeburg (Autor:in)
  • Maximilian Thormann - , Otto von Guericke University Magdeburg (Autor:in)
  • Fabian Flottmann - , Universität Hamburg (Autor:in)
  • Laurens Winkelmeier - , Universität Hamburg (Autor:in)
  • Elke R. Gizewski - , Medizinische Universität Innsbruck (Autor:in)
  • Lukas Mayer-Suess - , Medizinische Universität Innsbruck (Autor:in)
  • Tobias Boeckh-Behrens - , Technische Universität München (Autor:in)
  • Isabelle Riederer - , Technische Universität München (Autor:in)
  • Randolf Klingebiel - , Universitätsklinikum Ostwestfalen-Lippe (OWL) (Autor:in)
  • Björn Berger - , Universitätsklinikum Ostwestfalen-Lippe (OWL) (Autor:in)
  • Martin Schlunz-Hendann - , BG Klinikum Duisburg gGmbH (Autor:in)
  • Dominik Grieb - , BG Klinikum Duisburg gGmbH (Autor:in)
  • Ali Khanafer - , Klinikum Stuttgart (Autor:in)
  • Richard Du Mesnil De Rochemont - , Universitätsklinikum Frankfurt (Autor:in)
  • Christophe Arendt - , Universitätsklinikum Frankfurt (Autor:in)
  • Jens Altenbernd - , Gemeinschaftskrankenhaus Herdecke (Autor:in)
  • Jan Ulrich Schlump - , Gemeinschaftskrankenhaus Herdecke (Autor:in)
  • Adrian Ringelstein - , Kliniken Maria Hilf GmbH (Autor:in)
  • Vivian Jean Marcel Sanio - , Kliniken Maria Hilf GmbH (Autor:in)
  • Christian Loehr - , Klinikum Vest (Autor:in)
  • Agnes Maria Dahlke - , Klinikum Vest (Autor:in)
  • Carolin Brockmann - , Johannes Gutenberg-Universität Mainz (Autor:in)
  • Sebastian Reder - , Johannes Gutenberg-Universität Mainz (Autor:in)
  • Ulrich Sure - , Universität Duisburg-Essen (Autor:in)
  • Yan Li - , Universität Duisburg-Essen (Autor:in)
  • Ruben Mühl-Benninghaus - , Klinikum Lueneburg (Autor:in)
  • Thomas Rodt - , Klinikum Lueneburg (Autor:in)
  • Kai Kallenberg - , Klinikum Fulda gAG (Autor:in)
  • Alexandru Durutya - , Klinikum Fulda gAG (Autor:in)
  • Mohamed Elsharkawy - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Paul Stracke - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Mathias Gerhard Schumann - , Vivantes Klinikum Neukölln (Autor:in)
  • Alexander Bock - , Vivantes Klinikum Neukölln (Autor:in)

Abstract

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.

Details

OriginalspracheEnglisch
Aufsatznummere018723
Fachzeitschrift Journal of neuroInterventional surgery : JNIS
PublikationsstatusAngenommen/Im Druck - 2022
Peer-Review-StatusJa

Externe IDs

PubMed 35292572

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • COVID-19, Infection, Stroke, Thrombectomy