Impact of Procedure Time on Outcomes of Thrombectomy for Stroke

Journal of the American College of Cardiology
Ali AlawiehAlejandro M Spiotta

Abstract

Endovascular thrombectomy (ET) for acute ischemic stroke is the current standard of care. Although successful ET has high efficacy in improving functional outcomes, the decision to abort a long procedure remains a challenge. Longer procedure time (PT) has been associated with lower rates of functional independence. The objective of this study was to evaluate the impact of PT on outcomes and complications after ET using different techniques at a multicenter level and to define the risk of procedure extension in different patient cohorts. Patients undergoing ET with a stent retriever (SR) or a direct aspiration at first pass technique at 7 U.S. centers between June 2013 and February 2018 were reviewed from prospectively maintained databases that include baseline variables and technical and clinical outcomes. Multivariate analyses were used to assess impact of PT on 90-day modified Rankin scores, successful recanalization, post-procedural symptomatic hemorrhage (sICH), and complications. The study included 1,359 patients and demonstrated a decreased likelihood of good functional outcomes (modified Rankin score 0 to 2) when PT extended beyond 30 min (p < 0.01). Rates of sICH and complications increased exponentially with PT (doubli...Continue Reading

Citations

Oct 28, 2019·Journal of Neurointerventional Surgery·Ali AlawiehAlejandro Spiotta
Jul 9, 2020·Journal of Stroke·Francisco José Arruda Mont AlverneRaul Gomes Nogueira
Mar 20, 2020·Scientific Reports·Takaya KitanoTakeshi Morimoto
May 16, 2020·Stroke and Vascular Neurology·Omaditya KhannaPascal Jabbour
May 18, 2020·AJNR. American Journal of Neuroradiology·A P WessellG Jindal
Feb 23, 2020·Journal of the American College of Cardiology·Valentin Fuster
May 28, 2021·Journal of Neurointerventional Surgery·Devin V BageacReade De Leacy
Jun 3, 2021·The American Journal of the Medical Sciences·Adeola AwujoolaThomas I Nathaniel
Jun 5, 2021·Brain Circulation·Jeffrey Farooq, Jea Young Lee
Jul 9, 2021·Stroke; a Journal of Cerebral Circulation·François ZhuUNKNOWN ETIS Registry and Study Collaborators*
Sep 1, 2021·The Neuroradiology Journal·Ameer E HassanWondwossen G Tekle
Nov 3, 2021·BMJ Case Reports·Prashanth ReddySatya Narayana Patro

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