Endovascular Mechanical Thrombectomy in Large-Vessel Occlusion Ischemic Stroke Presenting with Low National Institutes of Health Stroke Scale: Systematic Review and Meta-Analysis

Griessenauer, Christoph J.; Medin, Caroline; Maingard, Julian; Chandra, Ronil V.; Ng, Watson; Brooks, Duncan Mark; Asadi, Hamed; Killer‐Oberpfalzer, Monika; Schirmer, Clemens M.; Moore, Justin M.; Ogilvy, Christopher S.; Thomas, Ajith J.; Phan, Kevin

doi:10.1016/j.wneu.2017.11.076

Cited by 55 publications

(35 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A previous meta-analysis study showed that patients with low NIHSS scores (< 6) experienced better functional outcomes following treatment with MT (14). Our study also demonstrated that patients treated with MT experienced superior clinical outcomes in low and high NIHSS scores.…”

Section: Discussionsupporting

confidence: 77%

“…The baseline characteristics of all patients are shown in Table 1. The mean age of patients treated with MT was 71.34 ± 12.02 years, 127 (59.91%) were men, the median OTD was 144 (60-189) min, the baseline NIHSS score was 15 (12)(13)(14)(15)(16)(17)(18)(19), 51 (24.06%) patients had wake-up stroke, and 104 (49.06%) underwent intravenous thrombolysis. Successful recanalization was achieved in 191 (90.09%) patients.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of an Unfavourable Outcome After Mechanical Thrombectomy for Acute Ischaemic Stroke

Deng¹,

Feng²,

Zhang³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Mounting evidence has shown that mechanical thrombectomy (MT) improves clinical outcomes for large vessel occlusions (LVOs) in patients with acute ischaemic stroke (AIS) of the anterior circulation. The present study aimed to provide a comprehensive analysis of risk factors associated with clinical outcomes in AIS patients receiving MT.Methods: A total of 212 consecutive patients who underwent MT for AIS were enrolled in the present study. Clinical characteristics were recorded at admission. Two endpoints were defined according to the 3-month modified Rankin scale (mRS) score after AIS (good outcome, mRS 0–2; and death, mRS 6). Additionally, we compared the clinical outcomes and safety of MT alone and bridging therapy in AIS patients.Results: Of the 212 patients treated with MT, 114 (53.77%) patients had a good outcome and 31 (14.62%) died. The incidence of a worse outcome after MT was significantly elevated in males and patients with high WBC counts, high admission blood glucose levels, high baseline NIHSS scores and a long interval time from groin puncture to reperfusion in AIS patients treated with MT after adjustment for covariates (P < 0.05); these risk factors were further confirmed by our constructed nomograms. In addition, we observed no significant benefit of bridging therapy compared to MT alone in AIS patients.Conclusions: The factors associated with an unfavourable outcome in AIS patients treated with MT were male sex, admission WBC, admission blood glucose, NIHSS, and the interval time from groin puncture to reperfusion.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Baseline Characteristicsmentioning

confidence: 99%

Predictors of an Unfavourable Outcome After Mechanical Thrombectomy for Acute Ischaemic Stroke

Deng¹,

Feng²,

Zhang³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In cases of acute threat to life or limb, thrombolysis or mechanical thrombectomy (MT) may be considered, particularly if expeditious resolution of thrombus burden is necessary . MT now plays an integral role in the acute response to embolic cerebrovascular accident and also in certain cases of acute myocardial infarction . MT appears to be infrequently used in pediatrics, even in situations of unsuccessful thrombolysis or when a patient is at high risk of bleeding with thrombolysis, in part because of an absence of size‐appropriate, purpose‐built thrombectomy devices .…”

Section: Introductionmentioning

confidence: 99%

“…5 MT now plays an integral role in the acute response to embolic cerebrovascular accident and also in certain cases of acute myocardial infarction. 8,9 MT appears to be infrequently used in pediatrics, even in situations of unsuccessful thrombolysis or when a patient is at high risk of bleeding with thrombolysis, in part because of an absence of size-appropriate, purpose-built thrombectomy devices. 10,11 Large introducer profiles prevent routine use of on-label MT devices in infants and small children.…”

mentioning

confidence: 99%

Initial experience with vascular plug devices for mechanical thrombectomy in symptomatic neonates and infants

McGovern

Qureshi

Goldstein

2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives To describe a novel technique for mechanical thrombectomy (MT) in young children. Background Acute thrombosis in children may be a cause of significant morbidity or mortality. MT options in children are limited due to patient and vessel size, prompting consideration of innovative approaches. Methods Two‐center review of children with symptomatic non‐cerebral thrombotic vessel occlusion. A novel approach to MT was performed using a deployed but unreleased amplatzer vascular plug (AVP) to “scrape” the target vessel in retrograde fashion, thereby harvesting the thrombus via the access sheath. Results AVP‐MT was performed in four patients at a median age of 2 months (range: 1 day‐11 months) and median weight of 5.6 kg (1.8–10.9). In two cases, AVP‐MT was performed in isolation in neonates on cervical extracorporeal membrane oxygenation (ECMO) support with cannula‐associated obstructive aortic and brachiocephalic thrombus. AVP‐MT was also performed as adjunctive therapy in a patient with single ventricle physiology and pulmonary artery thrombosis and in an infant with mitral valve endocarditis and femoral arterial thromboembolism. In all cases, AVP‐MT was used to successfully remove thrombus from the target vessel and restore arterial flow, without procedural complications. Recurrent thrombosis occurred in both neonates, due to persistence of the ECMO cannula, with subsequent mortality. The other children were free of recurrent thrombus at 2 and 34 months. Conclusions Acute relief of symptomatic thrombosis may be achieved using AVP‐MT in small children, although thrombosis frequently recurs, and clinical prognosis may remain poor. This strategy should be considered when alternative MT treatment options are not applicable.

show abstract

“…However, in this study, minor stroke was defined as a score of ≤5 points on the National Institutes of Health Stroke Scale (NIHSS). About one-third of these patients harbor a large vessel occlusion [5] and potentially develop a medium to large infarction with increased risk of hemorrhagic conversion. Thus, it would be useful to know how many patients in the study had an ischemic lesion on follow-up imaging and the size of the lesions.…”

mentioning

confidence: 99%

Early Dual Antiplatelet Therapy in Patients with Acute Minor Stroke Treated with Intravenous Thrombolysis

Mannino¹,

Cottone²

2020

Eur Neurol

View full text Add to dashboard Cite

Endovascular Mechanical Thrombectomy in Large-Vessel Occlusion Ischemic Stroke Presenting with Low National Institutes of Health Stroke Scale: Systematic Review and Meta-Analysis

Cited by 55 publications

References 10 publications

Predictors of an Unfavourable Outcome After Mechanical Thrombectomy for Acute Ischaemic Stroke

Predictors of an Unfavourable Outcome After Mechanical Thrombectomy for Acute Ischaemic Stroke

Initial experience with vascular plug devices for mechanical thrombectomy in symptomatic neonates and infants

Early Dual Antiplatelet Therapy in Patients with Acute Minor Stroke Treated with Intravenous Thrombolysis

Contact Info

Product

Resources

About