Collateral Vessels in Proximal Middle Cerebral Artery Occlusion: The ENDOSTROKE Study

Singer, Oliver C.; Berkefeld, Joachim; Nolte, Christian H.; Böhner, Georg; Reich, Arno; Wiesmann, Martin; Groeschel, Klaus; Boor, Stephan; Neumann‐Haefelin, Tobias; Hofmann, Erich; Stoll, Anett; Bormann, Albrecht; Liebeskind, David S

doi:10.1148/radiol.14140951

Cited by 80 publications

(62 citation statements)

References 16 publications

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“…This relatively high rate of ACA territory infarction might be secondary to insufficiency or absences of collaterals in the setting of concurrent or preceding ICA or MCA occlusion. 26,27 With a frequency of 38.5% of ACA infarction in patients with secondary emboli, our data are comparable with those in previous studies, in which the frequency was reported to be 32% and 40%, respectively. 7,8 Because primary occlusions are present longer than secondary occlusions before recanalization, the frequency of ACA infarction in patients with primary occlusions was higher (64.7%).…”

Section: Discussionsupporting

confidence: 91%

Mechanical Thrombectomy of Distal Occlusions in the Anterior Cerebral Artery: Recanalization Rates, Periprocedural Complications, and Clinical Outcome

Pfaff¹,

Herweh²,

Pham³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Patients with acute ischemic stroke in the anterior circulation are at risk for either primary or, following mechanical thrombectomy, secondary occlusion of the anterior cerebral artery. Because previous studies had only a limited informative value, we report our data concerning the frequency and location of distal anterior cerebral artery occlusions, recanalization rates, periprocedural complications, and clinical outcome.

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Section: Discussionsupporting

confidence: 91%

Mechanical Thrombectomy of Distal Occlusions in the Anterior Cerebral Artery: Recanalization Rates, Periprocedural Complications, and Clinical Outcome

Pfaff¹,

Herweh²,

Pham³

et al. 2015

AJNR Am J Neuroradiol

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“…Ribo et al 17) investigated the relationship between the final volume of cerebral infarction after thrombectomy and the outcome and reported that a favorable outcome cannot be expected unless the infarct volume is small particularly in older patients because older patients are less likely to recover by rehabilitation and more likely to suffer complications during hospitalization. 18) In this study, also, the time from the onset to recanalization was significantly longer in patients with a poor outcome in the older group. For improving the outcome in older patients, it is considered necessary to promptly recanalize occluded vessels and minimize the infarct volume.…”

Section: Discussionsupporting

confidence: 57%

Thrombectomy in Octogenarians in the Era of Stent Retriever: Is an Age Limit Necessary?

Tajima

Hayasaka

Ebihara

et al. 2017

JNET

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Objective:The results of thrombectomy in people aged 80 years and above were reviewed, and the necessity of an age limit was evaluated.Methods: Seventy eight patients who underwent thrombectomy at our hospital between July 2014 and September 2016 were divided into those aged <80 years and those aged ≥80 years, and the therapeutic results and outcome were evaluated. Results:The patients consisted of 25 aged ≥80 years (≥80 years group) and 53 aged <80 years (<80 years group). The mean time from puncture to recanalization was 56 and 65 minutes, respectively, and thrombolysis in cerebral infarction score of 2b or better recanalization was observed in 96.0 and 88.7%, respectively, with no significant difference in either parameter. Change of the approach route was necessary in five patients aged ≥80 years (20.0%). A favorable outcome with a modified Rankin scale (mRS) score of ≤2 was observed 3 months after the onset in 44.0 and 64.2%, respectively, being slightly lower in the ≥80 years group (P = 0.151). In the ≥80 years group, the time from the onset to recanalization was a poor prognostic factor (P = 0.048). Conclusion:In the patients aged ≥80 years, the recanalization rate, procedural time, and complication rate in thrombectomy were comparable to those in the patients aged <80 years, and no significant difference was observed in the outcome.Therefore, aggressive intervention without an age limit is considered recommendable in preoperatively activities of daily living (ADL)-independent elderly patients expected to be good candidates for simple thrombectomy. However, with the possibility of change in the approach route in mind, it is necessary to achieve recanalization more promptly in older patients.

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“…[1][2][3][4] Thus, these 2 parameters can be used as potentially valuable metrics for the selection of appropriate candidates for endovascular thrombectomy. 5,6 However, the acquisition of multidetector row CT images to assess clot burden and collaterals may delay the time from stroke onset to revascularization; this delay is primarily due to the time needed to transfer patients among different sites in a clinical facility.…”

mentioning

confidence: 99%

Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study

Yang

Niu

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The assessment of collaterals and clot burden in patients with acute ischemic stroke provides important information about treatment options and clinical outcome. Time-resolved C-arm conebeam CT angiography has the potential to provide accurate and reliable evaluations of collaterals and clot burden in the angiographic suite. Experience with this technique is extremely limited, and feasibility studies are needed to validate this technique. Our purpose was to present such a feasibility study.

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Collateral Vessels in Proximal Middle Cerebral Artery Occlusion: The ENDOSTROKE Study

Abstract: In this patient population, collateral vessel status independently predicted the pivotal outcome parameters of reperfusion, infarct size, and clinical outcome. These data underscore the utility of patient selection for EVT on the basis of collateral vessel status.

Cited by 80 publications

References 16 publications

Mechanical Thrombectomy of Distal Occlusions in the Anterior Cerebral Artery: Recanalization Rates, Periprocedural Complications, and Clinical Outcome

Mechanical Thrombectomy of Distal Occlusions in the Anterior Cerebral Artery: Recanalization Rates, Periprocedural Complications, and Clinical Outcome

Thrombectomy in Octogenarians in the Era of Stent Retriever: Is an Age Limit Necessary?

Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study

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