Xianjun Huang1,2, Qiankun Cai3, Lulu Xiao4, Mengmeng Gu5, Yuanlu Liu1, Zhiming Zhou2, Wen Sun6, Gelin Xu1,4, Xinfeng Liu7,8. 1. Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, 210002, Jiangsu, China. 2. Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China. 3. Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China. 4. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. 5. Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China. 6. Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, Anhui, China. sunwen_medneuro@163.com. 7. Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, 210002, Jiangsu, China. xfliu2@ustc.edu.cn. 8. Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, Anhui, China. xfliu2@ustc.edu.cn.
Abstract
BACKGROUND AND PURPOSE: Data on procedure time (PT) for mechanical thrombectomy (MT) are scarce. Moreover, the relationship among PT, postprocedural hemorrhagic transformation (HT), and functional outcomes in MT patients remains unclear. We investigated whether postprocedural HT mediated the relationship between PT and functional outcomes in patients with stent-retriever thrombectomy. METHODS: We retrospectively analyzed consecutive patients who underwent MT at two comprehensive stroke centers. PT was defined as the time from puncture to first successful recanalization or to abortion of the procedure if successful recanalization was not achieved. A favorable outcome was defined as a 90-day modified Rankin Scale score of 0-2. HT was classified using the European Cooperative Acute Stroke Study definition. RESULTS: Among 283 patients (mean age, 67.2 ± 11.9 years; male, 53.7%), 124 (43.8%) patients had a favorable outcome and 27 (9.5%) patients experienced symptomatic intracranial hemorrhage (sICH). Whether in the overall cohort or in the successful recanalization cohort, extended PT was an independent predictor for a poor outcome (per 30 min: OR 1.433, 95% CI 1.062-1.865, p = 0.019; OR 1.522, 95% CI 1.062-2.159, p = 0.020, respectively) and sICH (per 30 min: OR 1.391, 95% CI 1.030-1.865, p = 0.029; OR 1.716, 95% CI 1.161-2.648, p = 0.009, respectively). Moreover, postprocedural HT might partially explain the worse function outcomes in patients with an extended PT (the regression coefficient was changed by 28.2% and 28.1%, respectively). CONCLUSIONS: The PT is an independent predictor for 90-day outcomes in stent-retriever thrombectomy patients. Postprocedural HT was partially responsible for the worse outcome in patients who experienced a longer PT.
BACKGROUND AND PURPOSE: Data on procedure time (PT) for mechanical thrombectomy (MT) are scarce. Moreover, the relationship among PT, postprocedural hemorrhagic transformation (HT), and functional outcomes in MT patients remains unclear. We investigated whether postprocedural HT mediated the relationship between PT and functional outcomes in patients with stent-retriever thrombectomy. METHODS: We retrospectively analyzed consecutive patients who underwent MT at two comprehensive stroke centers. PT was defined as the time from puncture to first successful recanalization or to abortion of the procedure if successful recanalization was not achieved. A favorable outcome was defined as a 90-day modified Rankin Scale score of 0-2. HT was classified using the European Cooperative Acute Stroke Study definition. RESULTS: Among 283 patients (mean age, 67.2 ± 11.9 years; male, 53.7%), 124 (43.8%) patients had a favorable outcome and 27 (9.5%) patients experienced symptomatic intracranial hemorrhage (sICH). Whether in the overall cohort or in the successful recanalization cohort, extended PT was an independent predictor for a poor outcome (per 30 min: OR 1.433, 95% CI 1.062-1.865, p = 0.019; OR 1.522, 95% CI 1.062-2.159, p = 0.020, respectively) and sICH (per 30 min: OR 1.391, 95% CI 1.030-1.865, p = 0.029; OR 1.716, 95% CI 1.161-2.648, p = 0.009, respectively). Moreover, postprocedural HT might partially explain the worse function outcomes in patients with an extended PT (the regression coefficient was changed by 28.2% and 28.1%, respectively). CONCLUSIONS: The PT is an independent predictor for 90-day outcomes in stent-retriever thrombectomy patients. Postprocedural HT was partially responsible for the worse outcome in patients who experienced a longer PT.
Authors: A E Hassan; S A Chaudhry; J T Miley; R Khatri; S A Hassan; M F K Suri; A I Qureshi Journal: AJNR Am J Neuroradiol Date: 2012-07-19 Impact factor: 3.825
Authors: Pooja Khatri; Sharon D Yeatts; Mikael Mazighi; Joseph P Broderick; David S Liebeskind; Andrew M Demchuk; Pierre Amarenco; Janice Carrozzella; Judith Spilker; Lydia D Foster; Mayank Goyal; Michael D Hill; Yuko Y Palesch; Edward C Jauch; E Clarke Haley; Achala Vagal; Thomas A Tomsick Journal: Lancet Neurol Date: 2014-04-27 Impact factor: 44.182
Authors: Shadi Yaghi; Joshua Z Willey; Brett Cucchiara; Joshua N Goldstein; Nicole R Gonzales; Pooja Khatri; Louis J Kim; Stephan A Mayer; Kevin N Sheth; Lee H Schwamm Journal: Stroke Date: 2017-11-02 Impact factor: 7.914
Authors: Ali Alawieh; Alyssa K Pierce; Jan Vargas; Aquilla S Turk; Raymond D Turner; M Imran Chaudry; Alejandro M Spiotta Journal: J Neurointerv Surg Date: 2017-05-02 Impact factor: 5.836
Authors: Marc Ribo; Carlos A Molina; Erik Cobo; Neus Cerdà; Alejandro Tomasello; Helena Quesada; Maria Angeles De Miquel; Mónica Millan; Carlos Castaño; Xabier Urra; Luis Sanroman; Antoni Dàvalos; Tudor Jovin Journal: Stroke Date: 2016-03-08 Impact factor: 7.914
Authors: Jeffrey L Saver; Mayank Goyal; Aad van der Lugt; Bijoy K Menon; Charles B L M Majoie; Diederik W Dippel; Bruce C Campbell; Raul G Nogueira; Andrew M Demchuk; Alejandro Tomasello; Pere Cardona; Thomas G Devlin; Donald F Frei; Richard du Mesnil de Rochemont; Olvert A Berkhemer; Tudor G Jovin; Adnan H Siddiqui; Wim H van Zwam; Stephen M Davis; Carlos Castaño; Biggya L Sapkota; Puck S Fransen; Carlos Molina; Robert J van Oostenbrugge; Ángel Chamorro; Hester Lingsma; Frank L Silver; Geoffrey A Donnan; Ashfaq Shuaib; Scott Brown; Bruce Stouch; Peter J Mitchell; Antoni Davalos; Yvo B W E M Roos; Michael D Hill Journal: JAMA Date: 2016-09-27 Impact factor: 56.272
Authors: A P Wessell; H D P Carvalho; E Le; G Cannarsa; M J Kole; J A Stokum; T Chryssikos; T R Miller; S Chaturvedi; D Gandhi; K Yarbrough; S R Satti; G Jindal Journal: AJNR Am J Neuroradiol Date: 2020-05 Impact factor: 3.825
Authors: V M Srinivasan; T T Lazaro; A Srivatsan; P Cooper; M Phillips; R Garcia; S R Chen; J N Johnson; J-K Burkhardt; D E Collins; P Kan Journal: AJNR Am J Neuroradiol Date: 2020-12-24 Impact factor: 3.825