Multicenter evaluation of mechanical thrombectomy for distal medium vessel occlusions with National Institute of Health Stroke Scale Scores ≥ 6 and ≤ 6.

Autor:	Kühn AL; Division of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA., Puri AS; Division of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA., Salim HA; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Los Angeles, USA. Hamza.sleeem@gmail.com.; Brigham and Women's Hospital, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA. Hamza.sleeem@gmail.com.; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA. Hamza.sleeem@gmail.com., Musmar B; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Los Angeles, USA., Ghozy S; Departments of Neurological Surgery & Radiology, Mayo Clinic, Rochester, MN, USA., Siegler J; Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA., Shaikh H; Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA., Khalife J; Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA., Abdalkader M; Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA., Klein P; Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA., Nguyen TN; Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA., Heit JJ; Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA., Regenhardt RW; Brigham and Women's Hospital, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA., Diestro JDB; Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada., Cancelliere NM; Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada., Sweid A; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA., Naamani KE; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA., Hasan Z; Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada., Gopinathan A; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Amllay A; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA., Meyer L; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Dusart A; Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium., Bellante F; Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium., Forestier G; Neuroradiology Department, University Hospital of Limoges, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France., Rouchaud A; Neuroradiology Department, University Hospital of Limoges, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France., Saleme S; Neuroradiology Department, University Hospital of Limoges, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France., Mounayer C; Neuroradiology Department, University Hospital of Limoges, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, Limoges, France., Fiehler J; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Dyzmann C; Neuroradiology Department, Sana Kliniken, Lübeck GmbH, Lübeck, Germany., Kan PT; Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA., Singh J; Brigham and Women's Hospital, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA., Colasurdo M; Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA., Marnat G; Interventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France., Berge J; Interventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France., Barreau X; Interventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France., Sibon I; Neurology Department, Bordeaux University Hospital, Bordeaux, France., Nedelcu S; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA., Henninger N; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA., Marotta TR; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA., Stapleton CJ; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Los Angeles, USA., Rabinov JD; Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Los Angeles, USA., Ota T; Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan., Dofuku S; Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan., Yeo LL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tan BYQ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Martinez-Gutierrez JC; Department of Neurology, UTHealth McGovern Medical School, Houston, TX, USA., Salazar-Marioni S; Department of Neurology, UTHealth McGovern Medical School, Houston, TX, USA., Sheth S; Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy., Renieri L; Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy., Capirossi C; Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy., Mowla A; Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), 1200 North State St, Suite 3300, Los Angeles, CA, USA., Tjoumakaris SI; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA., Jabbour P; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA., Khandelwal P; Department of Endovascular Neurosurgery and Neuroradiology NJMS, Newark, NJ, USA., Biswas A; Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA., Clarençon F; Department of Neuroradiology, GRC BioFast, Sorbonne University. Paris VI, Pitié-Salpêtrière Hospital, Paris, France., Elhorany M; Department of Neuroradiology, GRC BioFast, Sorbonne University. Paris VI, Pitié-Salpêtrière Hospital, Paris, France., Premat K; Department of Neuroradiology, GRC BioFast, Sorbonne University. Paris VI, Pitié-Salpêtrière Hospital, Paris, France., Valente I; UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy., Pedicelli A; UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy., Filipe JP; Department of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário Do Porto, Porto, Portugal., Varela R; Department of Neurology, Centro Hospitalar Universitário Do Porto, Porto, Portugal., Quintero-Consuegra M; Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Gonzalez NR; Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Möhlenbruch MA; Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany., Jesser J; Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany., Costalat V; Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France., Ter Schiphorst A; Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France., Yedavalli V; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA., Harker P; Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA., Chervak L; Department of Neurology and Radiology, University of Cincinnati, Cincinnati, OH, USA., Aziz Y; Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA., Gory B; Department of Interventional Neuroradiology, Nancy University Hospital, Nancy, France., Stracke CP; Department of Radiology, Interventional Neuroradiology Section, University Medical Center, Münster, Germany., Hecker C; Departments of Neurology and Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria., Killer-Oberpfalzer M; Departments of Neurology and Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria., Griessenauer CJ; Departments of Neurology and Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria., Thomas A; Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA., Hsieh CY; Neurology Department, Sin-Lau Hospital, Tainan, Taiwan., Liebeskind DS; UCLA Stroke Center and Department of Neurology Department, UCLA, Los Angeles, CA, USA., Radu RA; Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France., Alexandre AM; UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy., Fahed R; Department of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada., Tancredi I; Department of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, ON, Canada., Faizy TD; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Weyland C; Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany., Lubicz B; Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium., Patel AB; Brigham and Women's Hospital, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA., Pereira VM; Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada., Guenego A; Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium., Dmytriw AA; Brigham and Women's Hospital, Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA. admytriw@mgh.harvard.edu.; Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. admytriw@mgh.harvard.edu.
Jazyk:	angličtina
Zdroj:	Journal of neurology [J Neurol] 2024 Sep; Vol. 271 (9), pp. 5853-5863. Date of Electronic Publication: 2024 Jul 05.
DOI:	10.1007/s00415-024-12537-4
Abstrakt:	Background: While mechanical thrombectomy is considered standard of care for large vessel occlusions, scientific evidence to support treatment for distal and medium vessel occlusions remains scarce. Purpose: To evaluate feasibility, safety, and outcomes in patients with low National Institute of Health Stroke Scale scores undergoing mechanical thrombectomy for treatment of distal medium vessel occlusions. Materials and Methods: Retrospective data review and analysis of prospectively maintained databases at 41 academic centers in North America, Asia, and Europe between January 2017 and January 2022. Characteristics and outcomes were compared between groups with low stroke scale score (≤ 6) versus and higher stroke scale scores (> 6). Propensity score matching using the optimal pair matching method and 1:1 ratio was performed. Results: Data were collected on a total of 1068 patients. After propensity score matching, there were a total of 676 patients included in the final analysis, with 338 patients in each group. High successful reperfusion rates were seen in both groups, 90.2% in ≤ 6 and 88.7% in the > 6 stroke scale groups. The frequency of excellent and good functional outcome was seen more common in low versus higher stroke scale score patients (64.5% and 81.1% versus 39.3% and 58.6%, respectively). The 90-day mortality rate observed in the ≤ 6 stroke scale group was 5.3% versus 13.3% in the > 6 stroke scale group. Conclusion: Mechanical thrombectomy in distal and medium vessel occlusions, specifically in patients with low stroke scale scores is feasible, though it may not necessarily improve outcomes over IVT. (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze:	MEDLINE
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