Periprocedural aspects in mechanical recanalization for acute stroke: data from the ENDOSTROKE registry |
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Authors: | Oliver C Singer Hans-Peter Haring Johannes Trenkler Christian H Nolte Georg Bohner Tobias Neumann-Haefelin Erich Hofmann Arno Reich Martin Wiesmann Kurt Niederkorn Hannes Deutschmann Matthias Bussmeyer Anastasios Mpotsaris Anett Stoll Albrecht Bormann Gabor C Petzold Horst Urbach Sebastian Jander Bernd Turowski Christian Weimar Marc Schlamann Klaus Gröschel Stephan Boor Joachim Berkefeld |
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Institution: | 1. Department of Neurology, Goethe University, Schleusenweg 2-16, 60528, Frankfurt/Main, Germany 2. Department of Neurology, Wagner-Jauregg Hospital, Linz, Austria 3. Institute for Radiology, Wagner-Jauregg Hospital, Linz, Austria 4. Department of Neurology, Charité Hospital, Berlin, Germany 5. Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, Charité Hospital, Berlin, Germany 6. Department of Neurology, Klinikum Fulda, Fulda, Germany 7. Institute for Diagnostic and Interventional Neuroradiology, Klinikum Fulda, Fulda, Germany 8. Department of Neurology, University Hospital Aachen, Aachen, Germany 9. Institute for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Aachen, Germany 10. Department of Neurology, Medical University of Graz, Graz, Austria 11. Department of Radiology, Division of Neuroradiology, Medical University of Graz, Graz, Austria 12. Department of Neurology, Vest Klinikum, Recklinghausen, Germany 13. Institute for Radiology and Neuroradiology, Vest Klinikum, Recklinghausen, Germany 14. Department of Neurology, Klinikum Altenburger Land, Altenburg, Germany 15. Institute for Radiology, Klinikum Altenburger Land, Altenburg, Germany 16. Department of Neurology and German Center for Neurodegenerative Diseases (DZNE), University Hospital Bonn, Bonn, Germany 17. Institute for Radiology, University Hospital Bonn, Bonn, Germany 18. Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany 19. Institute for Diagnostic and Interventional Radiology, Heinrich-Heine-University, Düsseldorf, Germany 20. Department of Neurology, University Hospital Essen, Essen, Germany 21. Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany 22. Department of Neurology, University Hospital Mainz, Mainz, Germany 23. Institute for Neuroradiology, University Hospital Mainz, Mainz, Germany 24. Institute for Neuroradiology, Goethe University, Frankfurt, Germany
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Abstract: | Introduction The ENDOSTROKE registry aims to accompany the spreading use of endovascular stroke treatment (EVT) in academic and non-academic hospitals. This analysis focuses on preprocedural imaging, patient handling and referral, as well as on different treatment modalities in mechanical recanalization. Methods Data for this study were from observational registry study in 12 stroke centers in Germany and Austria with online assessment of prespecified variables concerning endovascular stroke therapy. Results Data from 734 patients undergoing EVT were analyzed. Preferred imaging modality prior to EVT was CT (83 %) and CTA (78 %). In 95 %, EVT was performed under general anesthesia. In 55 % of patients, a combination of intravenous (IV) thrombolysis and EVT was used, followed by pure EVT (25 %), intra-arterial (IA) thrombolysis plus EVT (13 %) and IV?+?IA thrombolysis plus EVT (7 %). Intrahospital time delay until start of EVT was 91 and 99 min in anterior and vertebrobasilar circulation stroke, respectively. Average duration of EVT was 60 min. Overall thrombolysis in myocardial infarction grade 2/3 recanalization rate was 85 %. Stent retrievers were used in 75 %, being associated with higher recanalization rates than non-stent retrievers. Hemorrhagic complications (symptomatic and asymptomatic) occurred in 12 %. Overall vessel occlusion time was approximately 60 min longer in patients being referred from a primary care hospital for EVT. Conclusion This study gives an overview of procedure-related factors in current EVT practice. It gives estimates on preprocedural imaging modalities, periprocedural handling, and treatment combinations used for EVT. Patient referral for EVT from primary care hospitals is associated with longer vessel occlusion times. |
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