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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Hanna Styczen - , University of Duisburg-Essen (Author)
  • Volker Maus - , University Hospital Knappschaftskrankenhaus Bochum GmbH (Author)
  • Lukas Goertz - , University of Cologne (Author)
  • Martin Köhrmann - , University of Duisburg-Essen (Author)
  • Christoph Kleinschnitz - , University of Duisburg-Essen (Author)
  • Sebastian Fischer - , University Hospital Knappschaftskrankenhaus Bochum GmbH (Author)
  • Markus Möhlenbruch - , Heidelberg University  (Author)
  • Iris Mühlen - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Bernd Kallmünzer - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Franziska Dorn - , University of Bonn (Author)
  • Asadeh Lakghomi - , University of Bonn (Author)
  • Matthias Gawlitza - , TUD Dresden University of Technology (Author)
  • Daniel Kaiser - , Institute and Polyclinic of Diagnostic and Interventional Neuroradiology, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology (Author)
  • Joachim Klisch - , Fresenius AG (Author)
  • Donald Lobsien - , Fresenius AG (Author)
  • Stefan Rohde - , Klinikum Dortmund gGmbH (Author)
  • Gisa Ellrichmann - , Klinikum Dortmund gGmbH (Author)
  • Daniel Behme - , Otto von Guericke University Magdeburg (Author)
  • Maximilian Thormann - , Otto von Guericke University Magdeburg (Author)
  • Fabian Flottmann - , University of Hamburg (Author)
  • Laurens Winkelmeier - , University of Hamburg (Author)
  • Elke R. Gizewski - , Innsbruck Medical University (Author)
  • Lukas Mayer-Suess - , Innsbruck Medical University (Author)
  • Tobias Boeckh-Behrens - , Technical University of Munich (Author)
  • Isabelle Riederer - , Technical University of Munich (Author)
  • Randolf Klingebiel - , University Hospital Bielefeld (Author)
  • Björn Berger - , University Hospital Bielefeld (Author)
  • Martin Schlunz-Hendann - , BG Clincs Duisburg gGmbH (Author)
  • Dominik Grieb - , BG Clincs Duisburg gGmbH (Author)
  • Ali Khanafer - , Klinikum Stuttgart (Author)
  • Richard Du Mesnil De Rochemont - , University Hospital Frankfurt (Author)
  • Christophe Arendt - , University Hospital Frankfurt (Author)
  • Jens Altenbernd - , Witten/Herdecke University (Author)
  • Jan Ulrich Schlump - , Witten/Herdecke University (Author)
  • Adrian Ringelstein - , Clinics Maria Hilf GmbH (Author)
  • Vivian Jean Marcel Sanio - , Clinics Maria Hilf GmbH (Author)
  • Christian Loehr - , Klinikum Vest (Author)
  • Agnes Maria Dahlke - , Klinikum Vest (Author)
  • Carolin Brockmann - , Johannes Gutenberg University Mainz (Author)
  • Sebastian Reder - , Johannes Gutenberg University Mainz (Author)
  • Ulrich Sure - , University of Duisburg-Essen (Author)
  • Yan Li - , University of Duisburg-Essen (Author)
  • Ruben Mühl-Benninghaus - , Klinikum Lueneburg (Author)
  • Thomas Rodt - , Klinikum Lueneburg (Author)
  • Kai Kallenberg - , Klinikum Fulda gAG (Author)
  • Alexandru Durutya - , Klinikum Fulda gAG (Author)
  • Mohamed Elsharkawy - , University of Münster (Author)
  • Paul Stracke - , University of Münster (Author)
  • Mathias Gerhard Schumann - , Vivantes Klinikum Neukolln (Author)
  • Alexander Bock - , Vivantes Klinikum Neukolln (Author)

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

Original languageEnglish
Article numbere018723
Number of pages5
Journal Journal of neuroInterventional surgery : JNIS
Volume2022
Issue number14(9)
Publication statusAccepted/In press - 2022
Peer-reviewedYes

External IDs

PubMed 35292572

Keywords

ASJC Scopus subject areas

Keywords

  • COVID-19, Infection, Stroke, Thrombectomy

Library keywords