Factors Associated with Failure of Reperfusion in Endovascular Therapy for Acute Ischemic Stroke

  1. Flottmann, Fabian ORCID logo
  2. Broocks, Gabriel
  3. Faizy, Tobias Djamsched
  4. McDonough, Rosalie
  5. Watermann, Lucas
  6. Deb-Chatterji, Milani
  7. Thomalla, Götz
  8. Nolte, Christian H.
  9. Fiehler, Jens
  10. Leischner, Hannes
  11. Brekenfeld, Caspar
  12. Boeckh-Behrens, Tobias
  13. Wunderlich, Silke
  14. Reich, Arno
  15. Wiesmann, Martin
  16. Ernemann, Ulrike
  17. Hauser, Till-Karsten
  18. Siebert, Eberhard
  19. Zweynert, Sarah
  20. Bohner, Georg
  21. Ludolph, Alexander
  22. Henn, Karl-Heinz
  23. Pfeilschifter, Waltraud
  24. Wagner, Marlis
  25. Röther, Joachim
  26. Eckert, Bernd
  27. Berrouschot, Jörg
  28. Bormann, Albrecht
  29. Gerloff, Christian
  30. Hattingen, Elke
  31. Petzold, Gabor
  32. Thonke, Sven
  33. Bangard, Christopher
  34. Kraemer, Christoffer
  35. Dichgans, Martin
  36. Wollenweber, Frank
  37. Kellert, Lars
  38. Dorn, Franziska
  39. Herzberg, Moriz
  40. Psychogios, Marios
  41. Liman, Jan
  42. Petersen, Martina
  43. Stögbauer, Florian
  44. Kraft, Peter
  45. Pham, Mirko
  46. Braun, Michael
  47. Hamann, Gerhard F.
  48. Kastrup, Andreas
  49. Roth, Christian
  50. Gröschel, Klaus
  51. Uphaus, Timo
  52. Limmroth, Volker

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1000 Titel
  • Factors Associated with Failure of Reperfusion in Endovascular Therapy for Acute Ischemic Stroke
1000 Autor/in
  1. Flottmann, Fabian |
  2. Broocks, Gabriel |
  3. Faizy, Tobias Djamsched |
  4. McDonough, Rosalie |
  5. Watermann, Lucas |
  6. Deb-Chatterji, Milani |
  7. Thomalla, Götz |
  8. Nolte, Christian H. |
  9. Fiehler, Jens |
  10. Leischner, Hannes |
  11. Brekenfeld, Caspar |
  12. Boeckh-Behrens, Tobias |
  13. Wunderlich, Silke |
  14. Reich, Arno |
  15. Wiesmann, Martin |
  16. Ernemann, Ulrike |
  17. Hauser, Till-Karsten |
  18. Siebert, Eberhard |
  19. Zweynert, Sarah |
  20. Bohner, Georg |
  21. Ludolph, Alexander |
  22. Henn, Karl-Heinz |
  23. Pfeilschifter, Waltraud |
  24. Wagner, Marlis |
  25. Röther, Joachim |
  26. Eckert, Bernd |
  27. Berrouschot, Jörg |
  28. Bormann, Albrecht |
  29. Gerloff, Christian |
  30. Hattingen, Elke |
  31. Petzold, Gabor |
  32. Thonke, Sven |
  33. Bangard, Christopher |
  34. Kraemer, Christoffer |
  35. Dichgans, Martin |
  36. Wollenweber, Frank |
  37. Kellert, Lars |
  38. Dorn, Franziska |
  39. Herzberg, Moriz |
  40. Psychogios, Marios |
  41. Liman, Jan |
  42. Petersen, Martina |
  43. Stögbauer, Florian |
  44. Kraft, Peter |
  45. Pham, Mirko |
  46. Braun, Michael |
  47. Hamann, Gerhard F. |
  48. Kastrup, Andreas |
  49. Roth, Christian |
  50. Gröschel, Klaus |
  51. Uphaus, Timo |
  52. Limmroth, Volker |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-02-17
1000 Erschienen in
1000 Quellenangabe
  • 31(1):197-205
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00062-020-00880-8 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943507/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Aim!#!In acute large vessel occlusions, endovascular therapy (EVT) achieves flow restoration in the majority of cases; however, EVT fails to achieve sufficient reperfusion in a substantial minority of patients. This study aimed to identify predictors of failed reperfusion.!##!Methods!#!In this study 2211 patients from the German Stroke Registry who received EVT for anterior circulation stroke were retrospectively analyzed. Failure of reperfusion was defined as thrombolysis in cerebral infarction (TICI) grades 0/1/2a, and sufficient reperfusion as TICI 2b/3. In 1629 patients with complete datasets, associations between failure of reperfusion and baseline clinical data, comorbidities, location of occlusion, and procedural data were assessed with multiple logistic regression.!##!Results!#!Failure of reperfusion occurred in 371 patients (16.8%) and was associated with the following locations of occlusion: cervical internal carotid artery (ICA, adjusted odds ratio, OR 2.01, 95% confidence interval, CI 1.08-3.69), intracranial ICA without carotid T occlusion (adjusted OR 1.79, 95% CI 1.05-2.98), and M2 segment (adjusted OR 1.86, 95% CI 1.21-2.84). Failed reperfusion was also associated with cervical ICA stenosis (>70% stenosis, adjusted OR 2.90, 95% CI 1.69-4.97), stroke of other determined etiology by TOAST (Trial of ORG 10172 in acute stroke treatment) criteria (e.g. nonatherosclerotic vasculopathies, adjusted OR 2.73, 95% CI 1.36-5.39), and treatment given outside the usual working hours (adjusted OR 1.41, 95% CI 1.07-1.86). Successful reperfusion was associated with higher Alberta stroke program early CT score (ASPECTS) on initial imaging (adjusted OR 0.85, 95% CI 0.79-0.92), treatment with the patient under general anesthesia (adjusted OR 0.72, 95% CI 0.54-0.96), and concomitant ICA stenting in patients with ICA stenosis (adjusted OR 0.20, 95% CI 0.11-0.38).!##!Conclusion!#!Several factors are associated with failure of reperfusion, most notably occlusions of the proximal ICA and low ASPECTS on admission. Conversely, stent placement in the proximal ICA was associated with reperfusion success.
1000 Sacherschließung
lokal Female [MeSH]
lokal Stroke/therapy [MeSH]
lokal Thrombectomy [MeSH]
lokal Unsuccessful reperfusion
lokal Humans [MeSH]
lokal Treatment Outcome [MeSH]
lokal Retrospective Studies [MeSH]
lokal Mechanical thrombectomy
lokal Original Article
lokal Ischemic Stroke [MeSH]
lokal Reperfusion [MeSH]
lokal Large-vessel occlusion
lokal Stroke/diagnostic imaging [MeSH]
lokal Registry study
lokal Brain Ischemia/diagnostic imaging [MeSH]
lokal Endovascular treatment
lokal Brain Ischemia/therapy [MeSH]
lokal Endovascular Procedures [MeSH]
1000 Liste der Beteiligten
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