Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke

Fabrizio Sallustio; Ettore Nicolini; Valentina Saia; Giovanni Pracucci; Alfredo Paolo Mascolo; Federico Marrama; Roberto Gandini; Valerio Da Ros; Marina Diomedi; Fana Alemseged; Ilaria Casetta; Enrico Fainardi; Lucio Castellan; Massimo Del Sette; Nicola Limbucci; Patrizia Nencini; Mauro Bergui; Paolo Cerrato; Andrea Saletti; Alessandro De Vito; Samuele Cioni; Rossana Tassi; Luigi Simonetti; Andrea Zini; Maria Ruggiero; Marco Longoni; Agostino Tessitore; Ludovica Ferrau; Nicola Cavasin; Adriana Critelli; Stefano Vallone; Guido Bigliardi; Domenico Sergio Zimatore; Marco Petruzzellis; Andrea Boghi; Andrea Naldi; Alessio Comai; Elisa Dall'Ora; Giuseppina Sanfilippo; Alessandra Persico; Ivan Gallesio; Federica Sepe; Roberto Menozzi; Alessandro Pezzini; Michele Besana; Alessia Giossi; Antioco Sanna; Tiziana Tassinari; Nicola Burdi; Giovanni Boero; IRETAS Collaborators

doi:10.1007/s00415-024-12458-2

Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke

Fabrizio Sallustio, Ettore Nicolini, Valentina Saia, Giovanni Pracucci, Alfredo Paolo Mascolo, Federico Marrama, Roberto Gandini, Valerio Da Ros, Marina Diomedi, Fana Alemseged, Ilaria Casetta, Enrico Fainardi, Lucio Castellan, Massimo Del Sette, Nicola Limbucci, Patrizia Nencini, Mauro Bergui, Paolo Cerrato, Andrea Saletti, Alessandro De VitoSamuele Cioni, Rossana Tassi, Luigi Simonetti, Andrea Zini, Maria Ruggiero, Marco Longoni, Agostino Tessitore, Ludovica Ferrau, Nicola Cavasin, Adriana Critelli, Stefano Vallone, Guido Bigliardi, Domenico Sergio Zimatore, Marco Petruzzellis, Andrea Boghi, Andrea Naldi, Alessio Comai, Elisa Dall'Ora, Giuseppina Sanfilippo, Alessandra Persico, Ivan Gallesio, Federica Sepe, Roberto Menozzi, Alessandro Pezzini, Michele Besana, Alessia Giossi, Antioco Sanna, Tiziana Tassinari, Nicola Burdi, Giovanni Boero, IRETAS Collaborators

Krankenhaus Bozen

Publikation: Beitrag in Fachzeitschrift › Originalarbeit › Begutachtung

2 Quellenangaben (Web of Science)

Abstract

Background We aim to assess the association between procedural time and outcomes in patients in unsuccessful mechanical thrombectomy (MT) for anterior circulation acute stroke. Methods We conducted a cohort study on prospectively collected data from patients with M1 and/or M2 segment of middle cerebral artery occlusion with a thrombolysis in cerebral infarction 0-1 at the end of procedure. Primary outcome was 90-day poor outcome. Secondary outcomes were early neurological deterioration (END), symptomatic intracranial hemorrhage (sICH) according to ECASS II and sICH according to SITS-MOST. Results Among 852 patients, after comparing characteristics of favourable and poor outcome groups, logistic regression analysis showed age (OR: 1.04; 95%CI: 1.02-1.05; p < 0.001), previous TIA/stroke (OR: 0.23; 95%CI: 0.12-0.74; p = 0.009), M1 occlusion (OR: 1.69; 95%CI: 1.13-2.50; p = 0.01), baseline NIHSS (OR: 1.01; 95%CI: 1.06-1.13; p < 0.001) and procedural time (OR:1.00; 95% CI: 1.00-1.01; p = 0.003) as independent predictors poor outcome at 90 days. Concerning secondary outcomes, logistic regression analysis showed NIHSS (OR:0.96; 95%CI: 0.93-0.99; p = 0.008), general anaesthesia (OR:2.59; 95%CI: 1.52-4.40; p < 0.001), procedural time (OR: 1.00; 95% CI: 1.00-1.01; p = 0.002) and intraprocedural complications (OR: 1.89; 95%CI: 1.02-3.52; p = 0.04) as independent predictors of END. Bridging therapy (OR:2.93; 95%CI: 1.21-7.09; p = 0.017) was associated with sICH per SITS-MOST criteria whereas M1 occlusion (OR: 0.35; 95%CI: 0.18-0.69; p = 0.002), bridging therapy (OR: 2.02; 95%CI: 1.07-3.82; p = 0.03) and intraprocedural complications (OR: 5.55; 95%CI: 2.72-11.31; p < 0.001) were independently associated with sICH per ECASS II criteria. No significant association was found between the number of MT attempts and analyzed outcomes. Conclusions Regardless of the number of MT attempts and intraprocedural complications, procedural time was associated with poor outcome and END. We suggest a deeper consideration of procedural time when treating anterior circulation occlusions refractory to MT.

Originalsprache	Englisch
Seiten (von - bis)	5203-5212
Seitenumfang	10
Fachzeitschrift	JOURNAL OF NEUROLOGY
Jahrgang	271
Ausgabenummer	8
DOIs	https://doi.org/10.1007/s00415-024-12458-2
Publikationsstatus	Veröffentlicht - Aug. 2024

Zugriff auf Dokument

10.1007/s00415-024-12458-2

Andere Dateien und Links

Datensatz in Web of Science anzeigen

Fingerprint

Untersuchen Sie die Forschungsthemen von „Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke“. Zusammen bilden sie einen einzigartigen Fingerprint.

Dieses zitieren

Sallustio, F., Nicolini, E., Saia, V., Pracucci, G., Mascolo, A. P., Marrama, F., Gandini, R., Da Ros, V., Diomedi, M., Alemseged, F., Casetta, I., Fainardi, E., Castellan, L., Del Sette, M., Limbucci, N., Nencini, P., Bergui, M., Cerrato, P., Saletti, A., ... IRETAS Collaborators (2024). Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke. JOURNAL OF NEUROLOGY , 271(8), 5203-5212. https://doi.org/10.1007/s00415-024-12458-2

Sallustio, Fabrizio ; Nicolini, Ettore ; Saia, Valentina et al. / Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke : analysis from the Italian Registry of Endovascular Treatment in Acute Stroke. in: JOURNAL OF NEUROLOGY 2024 ; Jahrgang 271, Nr. 8. S. 5203-5212.

@article{4c5e6c8c8da14535afd823dafa5fc955,

title = "Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke",

abstract = "Background We aim to assess the association between procedural time and outcomes in patients in unsuccessful mechanical thrombectomy (MT) for anterior circulation acute stroke. Methods We conducted a cohort study on prospectively collected data from patients with M1 and/or M2 segment of middle cerebral artery occlusion with a thrombolysis in cerebral infarction 0-1 at the end of procedure. Primary outcome was 90-day poor outcome. Secondary outcomes were early neurological deterioration (END), symptomatic intracranial hemorrhage (sICH) according to ECASS II and sICH according to SITS-MOST. Results Among 852 patients, after comparing characteristics of favourable and poor outcome groups, logistic regression analysis showed age (OR: 1.04; 95%CI: 1.02-1.05; p < 0.001), previous TIA/stroke (OR: 0.23; 95%CI: 0.12-0.74; p = 0.009), M1 occlusion (OR: 1.69; 95%CI: 1.13-2.50; p = 0.01), baseline NIHSS (OR: 1.01; 95%CI: 1.06-1.13; p < 0.001) and procedural time (OR:1.00; 95% CI: 1.00-1.01; p = 0.003) as independent predictors poor outcome at 90 days. Concerning secondary outcomes, logistic regression analysis showed NIHSS (OR:0.96; 95%CI: 0.93-0.99; p = 0.008), general anaesthesia (OR:2.59; 95%CI: 1.52-4.40; p < 0.001), procedural time (OR: 1.00; 95% CI: 1.00-1.01; p = 0.002) and intraprocedural complications (OR: 1.89; 95%CI: 1.02-3.52; p = 0.04) as independent predictors of END. Bridging therapy (OR:2.93; 95%CI: 1.21-7.09; p = 0.017) was associated with sICH per SITS-MOST criteria whereas M1 occlusion (OR: 0.35; 95%CI: 0.18-0.69; p = 0.002), bridging therapy (OR: 2.02; 95%CI: 1.07-3.82; p = 0.03) and intraprocedural complications (OR: 5.55; 95%CI: 2.72-11.31; p < 0.001) were independently associated with sICH per ECASS II criteria. No significant association was found between the number of MT attempts and analyzed outcomes. Conclusions Regardless of the number of MT attempts and intraprocedural complications, procedural time was associated with poor outcome and END. We suggest a deeper consideration of procedural time when treating anterior circulation occlusions refractory to MT.",

keywords = "Acute stroke, Clinical outcome, Procedural time, Unsuccessful thrombectomy",

author = "Fabrizio Sallustio and Ettore Nicolini and Valentina Saia and Giovanni Pracucci and Mascolo, {Alfredo Paolo} and Federico Marrama and Roberto Gandini and {Da Ros}, Valerio and Marina Diomedi and Fana Alemseged and Ilaria Casetta and Enrico Fainardi and Lucio Castellan and {Del Sette}, Massimo and Nicola Limbucci and Patrizia Nencini and Mauro Bergui and Paolo Cerrato and Andrea Saletti and {De Vito}, Alessandro and Samuele Cioni and Rossana Tassi and Luigi Simonetti and Andrea Zini and Maria Ruggiero and Marco Longoni and Agostino Tessitore and Ludovica Ferrau and Nicola Cavasin and Adriana Critelli and Stefano Vallone and Guido Bigliardi and Zimatore, {Domenico Sergio} and Marco Petruzzellis and Andrea Boghi and Andrea Naldi and Alessio Comai and Elisa Dall'Ora and Giuseppina Sanfilippo and Alessandra Persico and Ivan Gallesio and Federica Sepe and Roberto Menozzi and Alessandro Pezzini and Michele Besana and Alessia Giossi and Antioco Sanna and Tiziana Tassinari and Nicola Burdi and Giovanni Boero and {IRETAS Collaborators}",

note = "Lehr-KH Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy; Teaching Hospital of Paracelsus Medical University (PMU), Salzburg, Austria als Author",

year = "2024",

month = aug,

doi = "10.1007/s00415-024-12458-2",

language = "English",

volume = "271",

pages = "5203--5212",

journal = "JOURNAL OF NEUROLOGY ",

issn = "0340-5354",

publisher = "Springer Nature",

number = "8",

}

Sallustio, F, Nicolini, E, Saia, V, Pracucci, G, Mascolo, AP, Marrama, F, Gandini, R, Da Ros, V, Diomedi, M, Alemseged, F, Casetta, I, Fainardi, E, Castellan, L, Del Sette, M, Limbucci, N, Nencini, P, Bergui, M, Cerrato, P, Saletti, A, De Vito, A, Cioni, S, Tassi, R, Simonetti, L, Zini, A, Ruggiero, M, Longoni, M, Tessitore, A, Ferrau, L, Cavasin, N, Critelli, A, Vallone, S, Bigliardi, G, Zimatore, DS, Petruzzellis, M, Boghi, A, Naldi, A, Comai, A, Dall'Ora, E, Sanfilippo, G, Persico, A, Gallesio, I, Sepe, F, Menozzi, R, Pezzini, A, Besana, M, Giossi, A, Sanna, A, Tassinari, T, Burdi, N, Boero, G & IRETAS Collaborators 2024, 'Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke', JOURNAL OF NEUROLOGY , Jg. 271, Nr. 8, S. 5203-5212. https://doi.org/10.1007/s00415-024-12458-2

Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke. / Sallustio, Fabrizio; Nicolini, Ettore; Saia, Valentina et al.
in: JOURNAL OF NEUROLOGY , Jahrgang 271, Nr. 8, 08.2024, S. 5203-5212.

Publikation: Beitrag in Fachzeitschrift › Originalarbeit › Begutachtung

TY - JOUR

T1 - Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke

T2 - analysis from the Italian Registry of Endovascular Treatment in Acute Stroke

AU - Sallustio, Fabrizio

AU - Nicolini, Ettore

AU - Saia, Valentina

AU - Pracucci, Giovanni

AU - Mascolo, Alfredo Paolo

AU - Marrama, Federico

AU - Gandini, Roberto

AU - Da Ros, Valerio

AU - Diomedi, Marina

AU - Alemseged, Fana

AU - Casetta, Ilaria

AU - Fainardi, Enrico

AU - Castellan, Lucio

AU - Del Sette, Massimo

AU - Limbucci, Nicola

AU - Nencini, Patrizia

AU - Bergui, Mauro

AU - Cerrato, Paolo

AU - Saletti, Andrea

AU - De Vito, Alessandro

AU - Cioni, Samuele

AU - Tassi, Rossana

AU - Simonetti, Luigi

AU - Zini, Andrea

AU - Ruggiero, Maria

AU - Longoni, Marco

AU - Tessitore, Agostino

AU - Ferrau, Ludovica

AU - Cavasin, Nicola

AU - Critelli, Adriana

AU - Vallone, Stefano

AU - Bigliardi, Guido

AU - Zimatore, Domenico Sergio

AU - Petruzzellis, Marco

AU - Boghi, Andrea

AU - Naldi, Andrea

AU - Comai, Alessio

AU - Dall'Ora, Elisa

AU - Sanfilippo, Giuseppina

AU - Persico, Alessandra

AU - Gallesio, Ivan

AU - Sepe, Federica

AU - Menozzi, Roberto

AU - Pezzini, Alessandro

AU - Besana, Michele

AU - Giossi, Alessia

AU - Sanna, Antioco

AU - Tassinari, Tiziana

AU - Burdi, Nicola

AU - Boero, Giovanni

AU - IRETAS Collaborators

N1 - Lehr-KH Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy; Teaching Hospital of Paracelsus Medical University (PMU), Salzburg, Austria als Author

PY - 2024/8

Y1 - 2024/8

N2 - Background We aim to assess the association between procedural time and outcomes in patients in unsuccessful mechanical thrombectomy (MT) for anterior circulation acute stroke. Methods We conducted a cohort study on prospectively collected data from patients with M1 and/or M2 segment of middle cerebral artery occlusion with a thrombolysis in cerebral infarction 0-1 at the end of procedure. Primary outcome was 90-day poor outcome. Secondary outcomes were early neurological deterioration (END), symptomatic intracranial hemorrhage (sICH) according to ECASS II and sICH according to SITS-MOST. Results Among 852 patients, after comparing characteristics of favourable and poor outcome groups, logistic regression analysis showed age (OR: 1.04; 95%CI: 1.02-1.05; p < 0.001), previous TIA/stroke (OR: 0.23; 95%CI: 0.12-0.74; p = 0.009), M1 occlusion (OR: 1.69; 95%CI: 1.13-2.50; p = 0.01), baseline NIHSS (OR: 1.01; 95%CI: 1.06-1.13; p < 0.001) and procedural time (OR:1.00; 95% CI: 1.00-1.01; p = 0.003) as independent predictors poor outcome at 90 days. Concerning secondary outcomes, logistic regression analysis showed NIHSS (OR:0.96; 95%CI: 0.93-0.99; p = 0.008), general anaesthesia (OR:2.59; 95%CI: 1.52-4.40; p < 0.001), procedural time (OR: 1.00; 95% CI: 1.00-1.01; p = 0.002) and intraprocedural complications (OR: 1.89; 95%CI: 1.02-3.52; p = 0.04) as independent predictors of END. Bridging therapy (OR:2.93; 95%CI: 1.21-7.09; p = 0.017) was associated with sICH per SITS-MOST criteria whereas M1 occlusion (OR: 0.35; 95%CI: 0.18-0.69; p = 0.002), bridging therapy (OR: 2.02; 95%CI: 1.07-3.82; p = 0.03) and intraprocedural complications (OR: 5.55; 95%CI: 2.72-11.31; p < 0.001) were independently associated with sICH per ECASS II criteria. No significant association was found between the number of MT attempts and analyzed outcomes. Conclusions Regardless of the number of MT attempts and intraprocedural complications, procedural time was associated with poor outcome and END. We suggest a deeper consideration of procedural time when treating anterior circulation occlusions refractory to MT.

AB - Background We aim to assess the association between procedural time and outcomes in patients in unsuccessful mechanical thrombectomy (MT) for anterior circulation acute stroke. Methods We conducted a cohort study on prospectively collected data from patients with M1 and/or M2 segment of middle cerebral artery occlusion with a thrombolysis in cerebral infarction 0-1 at the end of procedure. Primary outcome was 90-day poor outcome. Secondary outcomes were early neurological deterioration (END), symptomatic intracranial hemorrhage (sICH) according to ECASS II and sICH according to SITS-MOST. Results Among 852 patients, after comparing characteristics of favourable and poor outcome groups, logistic regression analysis showed age (OR: 1.04; 95%CI: 1.02-1.05; p < 0.001), previous TIA/stroke (OR: 0.23; 95%CI: 0.12-0.74; p = 0.009), M1 occlusion (OR: 1.69; 95%CI: 1.13-2.50; p = 0.01), baseline NIHSS (OR: 1.01; 95%CI: 1.06-1.13; p < 0.001) and procedural time (OR:1.00; 95% CI: 1.00-1.01; p = 0.003) as independent predictors poor outcome at 90 days. Concerning secondary outcomes, logistic regression analysis showed NIHSS (OR:0.96; 95%CI: 0.93-0.99; p = 0.008), general anaesthesia (OR:2.59; 95%CI: 1.52-4.40; p < 0.001), procedural time (OR: 1.00; 95% CI: 1.00-1.01; p = 0.002) and intraprocedural complications (OR: 1.89; 95%CI: 1.02-3.52; p = 0.04) as independent predictors of END. Bridging therapy (OR:2.93; 95%CI: 1.21-7.09; p = 0.017) was associated with sICH per SITS-MOST criteria whereas M1 occlusion (OR: 0.35; 95%CI: 0.18-0.69; p = 0.002), bridging therapy (OR: 2.02; 95%CI: 1.07-3.82; p = 0.03) and intraprocedural complications (OR: 5.55; 95%CI: 2.72-11.31; p < 0.001) were independently associated with sICH per ECASS II criteria. No significant association was found between the number of MT attempts and analyzed outcomes. Conclusions Regardless of the number of MT attempts and intraprocedural complications, procedural time was associated with poor outcome and END. We suggest a deeper consideration of procedural time when treating anterior circulation occlusions refractory to MT.

KW - Acute stroke

KW - Clinical outcome

KW - Procedural time

KW - Unsuccessful thrombectomy

UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001289773300083&DestLinkType=FullRecord&DestApp=WOS_CPL

U2 - 10.1007/s00415-024-12458-2

DO - 10.1007/s00415-024-12458-2

M3 - Original Article

C2 - 38836906

SN - 0340-5354

VL - 271

SP - 5203

EP - 5212

JO - JOURNAL OF NEUROLOGY

JF - JOURNAL OF NEUROLOGY

IS - 8

ER -

Sallustio F, Nicolini E, Saia V, Pracucci G, Mascolo AP, Marrama F et al. Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke. JOURNAL OF NEUROLOGY . 2024 Aug;271(8):5203-5212. doi: 10.1007/s00415-024-12458-2