Details der Publikation - International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy

International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy

© 2022 European Academy of Neurology..

BACKGROUND AND PURPOSE: Previous studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors.

METHODS: A cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted.

RESULTS: In this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID-19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID-19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23-0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12-0.77; p = 0.012). Moreover, endovascular complications, in-hospital mortality, and length of hospital stay were significantly higher among COVID-19 patients (p < 0.001).

CONCLUSION: COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID-19 patients with LVO were more often younger and had higher morbidity/mortality rates.

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:29
Enthalten in:	European journal of neurology - 29(2022), 11 vom: 21. Nov., Seite 3273-3287

Sprache:	Englisch

Beteiligte Personen:	Dmytriw, Adam A [VerfasserIn] Ghozy, Sherief [VerfasserIn] Sweid, Ahmad [VerfasserIn] Piotin, Michel [VerfasserIn] Bekelis, Kimon [VerfasserIn] Sourour, Nader [VerfasserIn] Raz, Eytan [VerfasserIn] Vela-Duarte, Daniel [VerfasserIn] Linfante, Italo [VerfasserIn] Dabus, Guilherme [VerfasserIn] Kole, Max [VerfasserIn] Martínez-Galdámez, Mario [VerfasserIn] Nimjee, Shahid M [VerfasserIn] Lopes, Demetrius K [VerfasserIn] Hassan, Ameer E [VerfasserIn] Kan, Peter [VerfasserIn] Ghorbani, Mohammad [VerfasserIn] Levitt, Michael R [VerfasserIn] Escalard, Simon [VerfasserIn] Missios, Symeon [VerfasserIn] Shapiro, Maksim [VerfasserIn] Clarençon, Fréderic [VerfasserIn] Elhorany, Mahmoud [VerfasserIn] Tahir, Rizwan A [VerfasserIn] Youssef, Patrick P [VerfasserIn] Pandey, Aditya S [VerfasserIn] Starke, Robert M [VerfasserIn] El Naamani, Kareem [VerfasserIn] Abbas, Rawad [VerfasserIn] Mansour, Ossama Y [VerfasserIn] Galvan, Jorge [VerfasserIn] Billingsley, Joshua T [VerfasserIn] Mortazavi, Abolghasem [VerfasserIn] Walker, Melanie [VerfasserIn] Dibas, Mahmoud [VerfasserIn] Settecase, Fabio [VerfasserIn] Heran, Manraj K S [VerfasserIn] Kuhn, Anna L [VerfasserIn] Puri, Ajit S [VerfasserIn] Menon, Bijoy K [VerfasserIn] Sivakumar, Sanjeev [VerfasserIn] Mowla, Ashkan [VerfasserIn] D'Amato, Salvatore [VerfasserIn] Zha, Alicia M [VerfasserIn] Cooke, Daniel [VerfasserIn] Vranic, Justin E [VerfasserIn] Regenhardt, Robert W [VerfasserIn] Rabinov, James D [VerfasserIn] Stapleton, Christopher J [VerfasserIn] Goyal, Mayank [VerfasserIn] Wu, Hannah [VerfasserIn] Cohen, Jake [VerfasserIn] Turkel-Parella, David [VerfasserIn] Xavier, Andrew [VerfasserIn] Waqas, Muhammad [VerfasserIn] Tutino, Vincent [VerfasserIn] Siddiqui, Adnan [VerfasserIn] Gupta, Gaurav [VerfasserIn] Nanda, Anil [VerfasserIn] Khandelwal, Priyank [VerfasserIn] Tiu, Cristina [VerfasserIn] Portela, Pere C [VerfasserIn] Perez de la Ossa, Natalia [VerfasserIn] Urra, Xabier [VerfasserIn] de Lera, Mercedes [VerfasserIn] Arenillas, Juan F [VerfasserIn] Ribo, Marc [VerfasserIn] Requena, Manuel [VerfasserIn] Piano, Mariangela [VerfasserIn] Pero, Guglielmo [VerfasserIn] De Sousa, Keith [VerfasserIn] Al-Mufti, Fawaz [VerfasserIn] Hashim, Zafar [VerfasserIn] Nayak, Sanjeev [VerfasserIn] Renieri, Leonardo [VerfasserIn] Du, Rose [VerfasserIn] Aziz-Sultan, Mohamed A [VerfasserIn] Liebeskind, David [VerfasserIn] Nogueira, Raul G [VerfasserIn] Abdalkader, Mohamad [VerfasserIn] Nguyen, Thanh N [VerfasserIn] Vigilante, Nicholas [VerfasserIn] Siegler, James E [VerfasserIn] Grossberg, Jonathan A [VerfasserIn] Saad, Hassan [VerfasserIn] Gooch, Michael R [VerfasserIn] Herial, Nabeel A [VerfasserIn] Rosenwasser, Robert H [VerfasserIn] Tjoumakaris, Stavropoula [VerfasserIn] Patel, Aman B [VerfasserIn] Tiwari, Ambooj [VerfasserIn] Jabbour, Pascal [VerfasserIn] North American Neurovascular COVID-19 (NAN-C) Consortium & Society of Vascular and Interventional Neurology (SVIN) Investigators [VerfasserIn]

Links:	Volltext

Themen:	COVID-19 Journal Article Large vessel occlusion Morbidity Mortality Multicenter Study Stroke

Anmerkungen:	Date Completed 10.10.2022 Date Revised 09.11.2022 published: Print-Electronic Citation Status MEDLINE

doi:	10.1111/ene.15493

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM343391805

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520			\|a BACKGROUND AND PURPOSE: Previous studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors
520			\|a METHODS: A cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted
520			\|a RESULTS: In this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID-19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID-19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23-0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12-0.77; p = 0.012). Moreover, endovascular complications, in-hospital mortality, and length of hospital stay were significantly higher among COVID-19 patients (p < 0.001)
520			\|a CONCLUSION: COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID-19 patients with LVO were more often younger and had higher morbidity/mortality rates
650		4	\|a Journal Article
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International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy

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