“Insights into vessel perforations during thrombectomy
Autor(a) principal: | |
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Data de Publicação: | 2024 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
Texto Completo: | http://hdl.handle.net/10362/172754 |
Resumo: | Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: V. S.-Z. discloses speaker fees from Medtronic Inc. (money paid to institution).\u2009M.R.L. discloses unrestricted educational grants from Medtronic and Stryker; consulting for Medtronic, Stereotaxis, Metis Innovative and Aeaean Advisers; equity interest in Proprio, Fluid Biomed, Stroke Diagnostics, Hyperion Surgical, Apertur; editorial board of Journal of NeuroInterventional Surgery; data safety monitoring board of Arsenal Medical. M.-N.P. discloses unrestricted grants from Swiss National Science Foundation (SNF), Bangerter-Rhyner Stiftung, Stryker Neurovascular Inc., Phenox GmbH, Medtronic Inc., Rapid Medical Inc., and Penumbra Inc for the DISTAL trial, grant for SPINNERS trial from Siemens Healthineers AG (money paid to institution) and the following speaker fees: Stryker Neurovascular Inc., Medtronic Inc., Penumbra Inc., Acandis GmbH, Phenox GmbH, Rapid Medical Inc. and Siemens Healthineers AG (money paid to institution). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: No project-specific funding was received for this study. V.S.-Z. is recipient of a research grant from Basel University, Basel, Switzerland. Publisher Copyright: © European Stroke Organisation 2024. |
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“Insights into vessel perforations during thrombectomyCharacteristics of a severe complication and the effect of thrombolysis”complicationintracranial hemorrhageintraoperativeStrokethrombectomythrombolysisClinical NeurologyCardiology and Cardiovascular MedicineFunding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: V. S.-Z. discloses speaker fees from Medtronic Inc. (money paid to institution).\u2009M.R.L. discloses unrestricted educational grants from Medtronic and Stryker; consulting for Medtronic, Stereotaxis, Metis Innovative and Aeaean Advisers; equity interest in Proprio, Fluid Biomed, Stroke Diagnostics, Hyperion Surgical, Apertur; editorial board of Journal of NeuroInterventional Surgery; data safety monitoring board of Arsenal Medical. M.-N.P. discloses unrestricted grants from Swiss National Science Foundation (SNF), Bangerter-Rhyner Stiftung, Stryker Neurovascular Inc., Phenox GmbH, Medtronic Inc., Rapid Medical Inc., and Penumbra Inc for the DISTAL trial, grant for SPINNERS trial from Siemens Healthineers AG (money paid to institution) and the following speaker fees: Stryker Neurovascular Inc., Medtronic Inc., Penumbra Inc., Acandis GmbH, Phenox GmbH, Rapid Medical Inc. and Siemens Healthineers AG (money paid to institution). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: No project-specific funding was received for this study. V.S.-Z. is recipient of a research grant from Basel University, Basel, Switzerland. Publisher Copyright: © European Stroke Organisation 2024.Introduction: Thrombectomy complications remain poorly explored. This study aims to characterize periprocedural intracranial vessel perforation including the effect of thrombolysis on patient outcomes. Patients and methods: In this multicenter retrospective cohort study, consecutive patients with vessel perforation during thrombectomy between January 2015 and April 2023 were included. Vessel perforation was defined as active extravasation on digital subtraction angiography. The primary outcome was modified Rankin Scale (mRS) at 90 days. Factors associated with the primary outcome were assessed using proportional odds models. Results: 459 patients with vessel perforation were included (mean age 72.5 ± 13.6 years, 59% female, 41% received thrombolysis). Mortality at 90 days was 51.9% and 16.3% of patients reached mRS 0–2 at 90 days. Thrombolysis was not associated with worse outcome at 90 days. Perforation of a large vessel (LV) as opposed to medium/distal vessel perforation was independently associated with worse outcome at 90 days (aOR 1.709, p = 0.04) and LV perforation was associated with poorer survival probability (HR 1.389, p = 0.021). Patients with active bleeding >20 min had worse survival probability, too (HR 1.797, p = 0.009). Thrombolysis was not associated with longer bleeding duration. Bleeding cessation was achieved faster by permanent vessel occlusion compared to temporary measures (median difference: 4 min, p < 0.001). Discussion and conclusion: Vessel perforation during thrombectomy is a severe and frequently fatal complication. This study does not suggest that thrombolysis significantly attributes to worse prognosis. Prompt cessation of active bleeding within 20 min is critical, emphasizing the need for interventionalists to be trained in complication management.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNSchulze-Zachau, VictorRommers, NikkiNtoulias, NikolaosBrehm, AlexKrug, NadjaTsogkas, IoannisMutke, MatthiasRusche, ThiloCervo, AmedeoRollo, ClaudiaMöhlenbruch, MarkusJesser, JessicaKreiser, KorneliaAlthaus, KatharinaRequena, ManuelRodrigo-Gisbert, MarcDobrocky, TomasSerrallach, Bettina L.Nolte, Christian H.Riegler, ChristophNawabi, JawedMaslias, ErrikosMichel, PatrikSaliou, GuillaumeManning, NathanMcQuinn, AlexanderTaylor, AlonMaurer, Christoph J.Berlis, AnsgarKaiser, Daniel P.O.Cuberi, AniMoreu, ManuelLópez-Frías, AlfonsoPérez-García, CarlosRautio, RiittaPauli, YlikotilaLimbucci, NicolaRenieri, LeonardoFragata, IsabelRodriguez-Ares, TaniaKirschke, Jan S.Schwarting, JulianAl Kasab, SamiSpiotta, Alejandro M.Abu Qdais, AhmadDmytriw, Adam A.Regenhardt, Robert W.Patel, Aman B.Pereira, Vitor MendesCancelliere, Nicole M.Schmeel, CarstenDorn, FranziskaSauer, MalteKarwacki, Grzegorz M.Khalife, JaneThomas, Ajith J.Shaikh, Hamza A.Commodaro, ChristianPileggi, MarcoSchwab, RolandBellante, FlavioDusart, AnneHofmeister, JeremyMachi, PaoloSamaniego, Edgar A.Ojeda, Diego J.Starke, Robert M.Abdelsalam, Ahmedvan den Bergh, FransDe Raedt, SylvieBester, MaximFlottmann, FabianWeiss, DanielKaschner, MariusKan, Peter T.Edhayan, GautamLevitt, Michael R.Raub, Spencer L.Katan, MiraFischer, UrsPsychogios, Marios Nikos2024-09-30T22:33:16Z2025-032025-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/172754eng2396-9873PURE: 100252683https://doi.org/10.1177/23969873241272542info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-05-12T01:44:55Zoai:run.unl.pt:10362/172754Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T18:55:21.104179Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
dc.title.none.fl_str_mv |
“Insights into vessel perforations during thrombectomy Characteristics of a severe complication and the effect of thrombolysis” |
title |
“Insights into vessel perforations during thrombectomy |
spellingShingle |
“Insights into vessel perforations during thrombectomy Schulze-Zachau, Victor complication intracranial hemorrhage intraoperative Stroke thrombectomy thrombolysis Clinical Neurology Cardiology and Cardiovascular Medicine |
title_short |
“Insights into vessel perforations during thrombectomy |
title_full |
“Insights into vessel perforations during thrombectomy |
title_fullStr |
“Insights into vessel perforations during thrombectomy |
title_full_unstemmed |
“Insights into vessel perforations during thrombectomy |
title_sort |
“Insights into vessel perforations during thrombectomy |
author |
Schulze-Zachau, Victor |
author_facet |
Schulze-Zachau, Victor Rommers, Nikki Ntoulias, Nikolaos Brehm, Alex Krug, Nadja Tsogkas, Ioannis Mutke, Matthias Rusche, Thilo Cervo, Amedeo Rollo, Claudia Möhlenbruch, Markus Jesser, Jessica Kreiser, Kornelia Althaus, Katharina Requena, Manuel Rodrigo-Gisbert, Marc Dobrocky, Tomas Serrallach, Bettina L. Nolte, Christian H. Riegler, Christoph Nawabi, Jawed Maslias, Errikos Michel, Patrik Saliou, Guillaume Manning, Nathan McQuinn, Alexander Taylor, Alon Maurer, Christoph J. Berlis, Ansgar Kaiser, Daniel P.O. Cuberi, Ani Moreu, Manuel López-Frías, Alfonso Pérez-García, Carlos Rautio, Riitta Pauli, Ylikotila Limbucci, Nicola Renieri, Leonardo Fragata, Isabel Rodriguez-Ares, Tania Kirschke, Jan S. Schwarting, Julian Al Kasab, Sami Spiotta, Alejandro M. Abu Qdais, Ahmad Dmytriw, Adam A. Regenhardt, Robert W. Patel, Aman B. Pereira, Vitor Mendes Cancelliere, Nicole M. Schmeel, Carsten Dorn, Franziska Sauer, Malte Karwacki, Grzegorz M. Khalife, Jane Thomas, Ajith J. Shaikh, Hamza A. Commodaro, Christian Pileggi, Marco Schwab, Roland Bellante, Flavio Dusart, Anne Hofmeister, Jeremy Machi, Paolo Samaniego, Edgar A. Ojeda, Diego J. Starke, Robert M. Abdelsalam, Ahmed van den Bergh, Frans De Raedt, Sylvie Bester, Maxim Flottmann, Fabian Weiss, Daniel Kaschner, Marius Kan, Peter T. Edhayan, Gautam Levitt, Michael R. Raub, Spencer L. Katan, Mira Fischer, Urs Psychogios, Marios Nikos |
author_role |
author |
author2 |
Rommers, Nikki Ntoulias, Nikolaos Brehm, Alex Krug, Nadja Tsogkas, Ioannis Mutke, Matthias Rusche, Thilo Cervo, Amedeo Rollo, Claudia Möhlenbruch, Markus Jesser, Jessica Kreiser, Kornelia Althaus, Katharina Requena, Manuel Rodrigo-Gisbert, Marc Dobrocky, Tomas Serrallach, Bettina L. Nolte, Christian H. Riegler, Christoph Nawabi, Jawed Maslias, Errikos Michel, Patrik Saliou, Guillaume Manning, Nathan McQuinn, Alexander Taylor, Alon Maurer, Christoph J. Berlis, Ansgar Kaiser, Daniel P.O. Cuberi, Ani Moreu, Manuel López-Frías, Alfonso Pérez-García, Carlos Rautio, Riitta Pauli, Ylikotila Limbucci, Nicola Renieri, Leonardo Fragata, Isabel Rodriguez-Ares, Tania Kirschke, Jan S. Schwarting, Julian Al Kasab, Sami Spiotta, Alejandro M. Abu Qdais, Ahmad Dmytriw, Adam A. Regenhardt, Robert W. Patel, Aman B. Pereira, Vitor Mendes Cancelliere, Nicole M. Schmeel, Carsten Dorn, Franziska Sauer, Malte Karwacki, Grzegorz M. Khalife, Jane Thomas, Ajith J. Shaikh, Hamza A. Commodaro, Christian Pileggi, Marco Schwab, Roland Bellante, Flavio Dusart, Anne Hofmeister, Jeremy Machi, Paolo Samaniego, Edgar A. Ojeda, Diego J. Starke, Robert M. Abdelsalam, Ahmed van den Bergh, Frans De Raedt, Sylvie Bester, Maxim Flottmann, Fabian Weiss, Daniel Kaschner, Marius Kan, Peter T. Edhayan, Gautam Levitt, Michael R. Raub, Spencer L. Katan, Mira Fischer, Urs Psychogios, Marios Nikos |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
dc.contributor.author.fl_str_mv |
Schulze-Zachau, Victor Rommers, Nikki Ntoulias, Nikolaos Brehm, Alex Krug, Nadja Tsogkas, Ioannis Mutke, Matthias Rusche, Thilo Cervo, Amedeo Rollo, Claudia Möhlenbruch, Markus Jesser, Jessica Kreiser, Kornelia Althaus, Katharina Requena, Manuel Rodrigo-Gisbert, Marc Dobrocky, Tomas Serrallach, Bettina L. Nolte, Christian H. Riegler, Christoph Nawabi, Jawed Maslias, Errikos Michel, Patrik Saliou, Guillaume Manning, Nathan McQuinn, Alexander Taylor, Alon Maurer, Christoph J. Berlis, Ansgar Kaiser, Daniel P.O. Cuberi, Ani Moreu, Manuel López-Frías, Alfonso Pérez-García, Carlos Rautio, Riitta Pauli, Ylikotila Limbucci, Nicola Renieri, Leonardo Fragata, Isabel Rodriguez-Ares, Tania Kirschke, Jan S. Schwarting, Julian Al Kasab, Sami Spiotta, Alejandro M. Abu Qdais, Ahmad Dmytriw, Adam A. Regenhardt, Robert W. Patel, Aman B. Pereira, Vitor Mendes Cancelliere, Nicole M. Schmeel, Carsten Dorn, Franziska Sauer, Malte Karwacki, Grzegorz M. Khalife, Jane Thomas, Ajith J. Shaikh, Hamza A. Commodaro, Christian Pileggi, Marco Schwab, Roland Bellante, Flavio Dusart, Anne Hofmeister, Jeremy Machi, Paolo Samaniego, Edgar A. Ojeda, Diego J. Starke, Robert M. Abdelsalam, Ahmed van den Bergh, Frans De Raedt, Sylvie Bester, Maxim Flottmann, Fabian Weiss, Daniel Kaschner, Marius Kan, Peter T. Edhayan, Gautam Levitt, Michael R. Raub, Spencer L. Katan, Mira Fischer, Urs Psychogios, Marios Nikos |
dc.subject.por.fl_str_mv |
complication intracranial hemorrhage intraoperative Stroke thrombectomy thrombolysis Clinical Neurology Cardiology and Cardiovascular Medicine |
topic |
complication intracranial hemorrhage intraoperative Stroke thrombectomy thrombolysis Clinical Neurology Cardiology and Cardiovascular Medicine |
description |
Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: V. S.-Z. discloses speaker fees from Medtronic Inc. (money paid to institution).\u2009M.R.L. discloses unrestricted educational grants from Medtronic and Stryker; consulting for Medtronic, Stereotaxis, Metis Innovative and Aeaean Advisers; equity interest in Proprio, Fluid Biomed, Stroke Diagnostics, Hyperion Surgical, Apertur; editorial board of Journal of NeuroInterventional Surgery; data safety monitoring board of Arsenal Medical. M.-N.P. discloses unrestricted grants from Swiss National Science Foundation (SNF), Bangerter-Rhyner Stiftung, Stryker Neurovascular Inc., Phenox GmbH, Medtronic Inc., Rapid Medical Inc., and Penumbra Inc for the DISTAL trial, grant for SPINNERS trial from Siemens Healthineers AG (money paid to institution) and the following speaker fees: Stryker Neurovascular Inc., Medtronic Inc., Penumbra Inc., Acandis GmbH, Phenox GmbH, Rapid Medical Inc. and Siemens Healthineers AG (money paid to institution). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: No project-specific funding was received for this study. V.S.-Z. is recipient of a research grant from Basel University, Basel, Switzerland. Publisher Copyright: © European Stroke Organisation 2024. |
publishDate |
2024 |
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2024-09-30T22:33:16Z 2025-03 2025-03-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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