Τίτλος:
Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and objective: We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies. Methods: We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014–2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST. Results: Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44–47), 46.0% (42–50), 38% (35–41) and 37% (35–41), respectively; death was 19.2% (19–21), 15.3% (12.7–18.4), 29.2% (27–32) and 28.6% (27–31); and SICH was 3.6% (3–4), 4.4% (3.0–6.4), 5.8% (4.7–7.1) and not available. Conclusion: Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies. © 2021 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine
Συγγραφείς:
Ahmed, N.
Mazya, M.
Nunes, A.P.
Moreira, T.
Ollikainen, J.P.
Escudero-Martinez, I.
Bigliardi, G.
Dorado, L.
Dávalos, A.
Egido, J.A.
Tassi, R.
Strbian, D.
Zini, A.
Nichelli, P.
Herzig, R.
Jurák, L.
Hurtikova, E.
Tsivgoulis, G.
Peeters, A.
Nevšímalová, M.
Brozman, M.
Cavallo, R.
Lees, K.R.
Mikulik, R.
Toni, D.
Holmin, S.
Περιοδικό:
Journal of Internal Medicine
Εκδότης:
John Wiley and Sons Inc
Λέξεις-κλειδιά:
acute ischemic stroke; aged; anterior cerebral artery; artery occlusion; artery puncture; Article; brain hemorrhage; clinical article; clinical outcome; controlled study; female; follow up; human; internal carotid artery; male; middle cerebral artery; observational study; percutaneous thrombectomy; Rankin scale; recanalization; sensitivity analysis; artery; brain ischemia; cerebrovascular accident; endovascular surgery; randomized controlled trial (topic); retrospective study; thrombectomy; treatment outcome, Arteries; Brain Ischemia; Endovascular Procedures; Humans; Intracranial Hemorrhages; Randomized Controlled Trials as Topic; Retrospective Studies; Stroke; Thrombectomy; Treatment Outcome
