Journal article
Repeated Mechanical Endovascular Thrombectomy for Recurrent Large Vessel Occlusion: A Multicenter Experience
Stroke (1970), Vol.52(6), pp.1967-1973
06/2021
DOI: 10.1161/STROKEAHA.120.033393
PMID: 33910367
Abstract
Background and Purpose:
Mechanical thrombectomy (MT) is now the standard of care for large vessel occlusion (LVO) stroke. However, little is known about the frequency and outcomes of repeat MT (rMT) for patients with recurrent LVO.
Methods:
This is a retrospective multicenter cohort of patients who underwent rMT at 6 tertiary institutions in the United States between March 2016 and March 2020. Procedural, imaging, and outcome data were evaluated. Outcome at discharge was evaluated using the modified Rankin Scale.
Results:
Of 3059 patients treated with MT during the study period, 56 (1.8%) underwent at least 1 rMT. Fifty-four (96%) patients were analyzed; median age was 64 years. The median time interval between index MT and rMT was 2 days; 35 of 54 patients (65%) experienced recurrent LVO during the index hospitalization. The mechanism of stroke was cardioembolism in 30 patients (56%), intracranial atherosclerosis in 4 patients (7%), extracranial atherosclerosis in 2 patients (4%), and other causes in 18 patients (33%). A final TICI recanalization score of 2b or 3 was achieved in all 54 patients during index MT (100%) and in 51 of 54 patients (94%) during rMT. Thirty-two of 54 patients (59%) experienced recurrent LVO of a previously treated artery, mostly the pretreated left MCA (23 patients, 73%). Fifty of the 54 patients (93%) had a documented discharge modified Rankin Scale after rMT: 15 (30%) had minimal or no disability (modified Rankin Scale score ≤2), 25 (50%) had moderate to severe disability (modified Rankin Scale score 3–5), and 10 (20%) died.
Conclusions:
Almost 2% of patients treated with MT experience recurrent LVO, usually of a previously treated artery during the same hospitalization. Repeat MT seems to be safe and effective for attaining vessel recanalization, and good outcome can be expected in 30% of patients.
Details
- Title: Subtitle
- Repeated Mechanical Endovascular Thrombectomy for Recurrent Large Vessel Occlusion: A Multicenter Experience
- Creators
- Ghada A. Mohamed - Henry Ford HospitalHassan Aboul Nour - Department of Neurology, Henry Ford Hospital, Detroit, MI (G.A.M., H.A.N., L.S., D.M., A.B.C.)Raul G. Nogueira - Emory University HospitalMahmoud H. Mohammaden - Emory University HospitalDiogo C. Haussen - Emory University HospitalAlhamza R. Al-Bayati - Emory University HospitalThanh N. Nguyen - Boston Medical CenterMohamad Abdalkader - Boston Medical CenterArtem Kaliaev - Boston Medical CenterAlice Ma - Royal North Shore HospitalJohanna Fifi - Icahn School of Medicine at Mount SinaiJacob Morey - Icahn School of Medicine at Mount SinaiDileep R. Yavagal - University of MiamiVasu Saini - University of MiamiSantiago Ortega-Gutierrez - University of IowaMudassir Farooqui - University of IowaCynthia B. Zevallos - University of IowaDarko Quispe-Orozco - University of IowaLonni Schultz - Henry Ford HospitalMaximilian Kole - Henry Ford HospitalDaniel Miller - Henry Ford HospitalStephan A. Mayer - New York Medical CollegeHoria Marin - Henry Ford HospitalAlex Bou Chebl - Department of Neurology, Henry Ford Hospital, Detroit, MI (G.A.M., H.A.N., L.S., D.M., A.B.C.)
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.52(6), pp.1967-1973
- DOI
- 10.1161/STROKEAHA.120.033393
- PMID
- 33910367
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 06/2021
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984302199302771
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