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5. Endovascular thrombectomy for childhood stroke (Save ChildS Pro): an international, multicentre, prospective registry study

Author

Sporns, Peter B, Bhatia, Kartik, Abruzzo, Todd, Pabst, Lisa, Fraser, Stuart, Chung, Melissa G, Lo, Warren, Othman, Ahmed, Steinmetz, Sebastian, Jensen-Kondering, Ulf, Schob, Stefan, Kaiser, Daniel P O, Marik, Wolfgang, Wendl, Christina, Kleffner, Ilka, Henkes, Hans, Kraehling, Hermann, Nguyen-Kim, Thi Dan Linh, Chapot, René, Yilmaz, Umut, Wang, Furene, Hafeez, Muhammad Ubaid, Requejo, Flavio, Limbucci, Nicola, Kauffmann, Birgit, Möhlenbruch, Markus, Nikoubashman, Omid, Schellinger, Peter D, Musolino, Patricia, Alawieh, Ali, Wilson, Jenny, Grieb, Dominik, Gersing, Alexandra S, Liebig, Thomas, Olivieri, Martin, Schwabova, Jaroslava Paulasova, Tomek, Ales, Papanagiotou, Panagiotis, Boulouis, Grégoire, Naggara, Olivier, Fox, Christine K, Orlov, Kirill, Kuznetsova, Alexandra, Parra-Farinas, Carmen, Muthusami, Prakash, Regenhardt, Robert W, Dmytriw, Adam A, Burkard, Tanja, Martinez, Mesha, Brechbühl, Daniel, Steinlin, Maja, Sun, Lisa R, Hassan, Ameer E, Kemmling, André, Lee, Sarah, Fullerton, Heather J, Fiehler, Jens, Psychogios, Marios-Nikos, and Wildgruber, Moritz

Published
2024
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7. Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis

Author

Bilgin, Cem, Ibrahim, Mohamed, Azzam, Ahmed Y., Ghozy, Sherief, Elswedy, Adam, Kobeissi, Hassan, Sobhi Jabal, Mohamed, Kadirvel, Ramanathan, Boulouis, Grégoire, Naggara, Olivier, Fiehler, Jens, Psychogios, Marios, Lee, Sarah, Wildgruber, Moritz, Kemmling, André, Al-Mufti, Fawaz, Kossorotoff, Manoelle, Sporns, Peter B., and Kallmes, David F.

Published
2023
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9. A Prospective Multicenter Registry on Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke (Save ChildS Pro)

Author

Sporns, Peter B, Kemmling, André, Lee, Sarah, Fullerton, Heather, Kunz, Wolfgang G, Wilson, Jenny L, Mackay, Mark T, Steinlin, Maja, Fiehler, Jens, Psychogios, Marios, and Wildgruber, Moritz

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Clinical Research, Pediatric, Clinical Trials and Supportive Activities, Stroke, Brain Disorders, stroke, ischemic stroke, arterial ischemic stroke, thrombectomy, mechanical thrombectomy, intravenous thrombolysis, childhood stroke, pediatric stroke, Psychology, Clinical sciences, Biological psychology
Abstract

Rationale: Early evidence for the benefit of mechanical thrombectomy (MT) in pediatric patients with intracranial large vessel occlusion has been shown in previous retrospective cohorts. Higher-level evidence is needed to overcome the limitations of these studies such as the lack of a control group and the retrospective design. Randomized trials will very likely not be feasible, and several open questions remain, for example, the impact of arteriopathic etiologies or a possible lower age limit for MT. Save ChildS Pro therefore aims to demonstrate the safety and effectiveness of MT in pediatric patients compared to the best medical management and intravenous thrombolysis. Design: Save ChildS Pro is designed as a worldwide multicenter prospective registry comparing the safety and effectiveness of MT to the best medical care alone in the treatment of pediatric arterial ischemic stroke (AIS). It will include pediatric patients (

Published
2021

10. Neuroimaging of Pediatric Intracerebral Hemorrhage.

Author

Sporns, Peter B, Psychogios, Marios-Nikos, Fullerton, Heather J, Lee, Sarah, Naggara, Olivier, and Boulouis, Grégoire

Subjects
intracerebral haemorrhage, neuroimaging, paediatric stroke, Clinical Sciences
Abstract

Hemorrhagic strokes account for half of all strokes seen in children, and the etiologies of these hemorrhagic strokes differ greatly from those seen in adult patients. This review gives an overview about incidence and etiologies as well as presentation of children with intracerebral hemorrhage and with differential diagnoses in the emergency department. Most importantly it describes how neuroimaging of children with intracerebral hemorrhage should be tailored to specific situations and clinical contexts and recommends specific imaging protocols for acute and repeat imaging. In this context it is important to keep in mind the high prevalence of underlying vascular lesions and adapt the imaging protocol accordingly, meaning that vascular imaging plays a key role regardless of modality. Magnetic resonance imaging (MRI), including advanced sequences, should be favored whenever possible at the acute phase.

Published
2020

11. Clinical Outcome and Quality of Life of Multimodal Treatment of Extracranial Arteriovenous Malformations: The APOLLON Study Protocol

Author

Schmidt, Vanessa F., Masthoff, Max, Vielsmeier, Veronika, Seebauer, Caroline T., Cangir, Özlem, Meyer, Lutz, Mükke, Antje, Lang, Werner, Schmid, Axel, Sporns, Peter B., Brill, Richard, Wohlgemuth, Walter A., da Silva, Natascha Platz Batista, Seidensticker, Max, Schinner, Regina, Küppers, Julia, Häberle, Beate, Haubner, Frank, Ricke, Jens, Zenker, Martin, Kimm, Melanie A., and Wildgruber, Moritz

Published
2023
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12. Correction to: Non-contrast computed tomography features predict intraventricular hemorrhage growth

Author

Nawabi, Jawed, Schlunk, Frieder, Dell’Orco, Andrea, Elsayed, Sarah, Mazzacane, Federico, Desser, Dmitriy, Vu, Ly, Vogt, Estelle, Cao, Haoyin, Böhmer, Maik F. H., Akkurt, Burak Han, Sporns, Peter B., Pasi, Marco, Jensen-Kondering, Ulf, Broocks, Gabriel, Penzkofer, Tobias, Fiehler, Jens, Padovani, Alessandro, Hanning, Uta, and Morotti, Andrea

Published
2023
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14. Image-Guided Embolotherapy of Arteriovenous Malformations of the Face

Author

Schmidt, Vanessa F., Masthoff, Max, Brill, Richard, Sporns, Peter B., Köhler, Michael, Schulze-Zachau, Victor, Takes, Martin, Ehrl, Denis, Puhr-Westerheide, Daniel, Kunz, Wolfgang G., Shemwetta, Mwivano Dunstan, Mbuguje, Eric M., Naif, Azza A., Sarkar, Abizer, Ricke, Jens, Seidensticker, Max, Wohlgemuth, Walter A., and Wildgruber, Moritz

Published
2022
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16. Mechanical Thrombectomy for Pediatric Stroke: Focal Cerebral Arteriopathy Versus Cardioembolic Etiologies—Pooled Analysis of the Save ChildS and KidClot Cohort.

Author

Boucherit, Julien, Psychogios, Marios, Kossorotoff, Manoëlle, Fiehler, Jens, Kerleroux, Basile, Kemmling, André, Naggara, Olivier, Lee, Sarah, Nguyen‐Kim, Thi Dan Linh, Eugene, François, Wildgruber, Moritz, Boulouis, Gregoire, and Sporns, Peter B.

Subjects
STROKE patients, CEREBRAL infarction, ISCHEMIC stroke, CHILD patients, REGRESSION analysis
Abstract

Background: The study aimed to compare outcomes of mechanical thrombectomy (MT) in pediatric patients with acute ischemic stroke (AIS) caused by focal cerebral arteriopathy (FCA) versus cardioembolism (CE). Methods: Data from the Save ChildS and KidClot cohorts were merged. Children with AIS because of FCA or CE that underwent MT were included. The study used the Childhood Arterial Ischemic Stroke Standardized Classification and Diagnostic Evaluation (CASCADE) for stroke cause assessment. Descriptive statistics and multivariable regression models were used to analyze final modified thrombolysis in cerebral infarction (mTICI) scores, periprocedural complications, and functional outcomes assessed by the modified Rankin scale (mRS) at 6 to 12 months. Results: The analysis included 60 children with 14 FCA and 46 CE cases. CE etiology was associated with better revascularization (good to excellent thrombolysis in cerebral infarction scores) and shift toward better outcomes (common adjusted odds ratio of mRs for CE vs FCA: 0.27, 95% CI: [0.06–0.97], p = 0.039), with no difference in favorable outcome rates. FCA was associated with significantly lower rates of excellent revascularization (21% vs 65%, p < 0.001). No difference in complications' rates was observed between the groups (7.2% in FCA vs 5.5%, p = 0.69). Interpretation: We found that pediatric AIS because of CE etiology has more favorable procedural outcomes compared to FCA following MT. This translated to mixed functional outcomes that may be more favorable in the CE group. These findings highlight the need for further research to refine treatment protocols for pediatric stroke, particularly in understanding and managing FCA in children. ANN NEUROL 2025;97:195–201 [ABSTRACT FROM AUTHOR]

Published
2025
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17. Location specific rupture risk of intracranial aneurysms: case of ophthalmic aneurysms.

Author

Chiaroni, Pierre-Marie, Guerra, Xavier, Cortese, Jonathan, Burel, Julien, Courret, Thomas, dit Beaufils, Pacome Constant, Agripnidis, Thibault, Leonard-Lorant, Ian, Fauché, Cédric, Adeniran Bankole, Nourou Dine, Forestier, Géraud, L'allinec, Vincent, Sporns, Peter B., Gueton, Gaelle, Lorena, Nico, Psychogios, Marios-Nikos, Girot, Jean-Baptiste, Rouchaud, Aymeric, Janot, Kevin, and Raynaud, Nicolas

Subjects
ANEURYSMS, INTRACRANIAL aneurysms, RISK assessment, CEREBRAL angiography, OPHTHALMIC artery, SUBARACHNOID hemorrhage, LONGITUDINAL method, ODDS ratio, RESEARCH, CONFIDENCE intervals, COMPARATIVE studies
Abstract

Background Aneurysm location is a key element in predicting the rupture risk of an intracranial aneurysm. A common impression suggests that pure ophthalmic aneurysms are under-represented in ruptured intracranial aneurysms (RIAs). The purpose of this study was to specifically evaluate the risk of rupture of ophthalmic aneurysms compared with other aneurysm locations. Methods This multicenter study compared the frequency of ophthalmic aneurysms in a prospective cohort of RIAs admitted to 13 neuroradiology centers between January 2021 and March 2021, with a retrospective cohort of patients with unruptured intracranial aneurysms (UIAs) who underwent cerebral angiography at the same neuroradiology centers during the same time period. Results 604 intracranial aneurysms were included in this study (355 UIAs and 249 RIAs; mean age 57 years (IQR 49-65); women 309/486, 64%). Mean aneurysm size was 6.0 mm (5.3 mm for UIAs, 7.0 mm for RIAs; P<0.0001). Aneurysm shape was irregular for 37% UIAs and 73% RIAs (P<0.0001). Ophthalmic aneurysms frequency was 14.9% of UIAs (second most common aneurysm location) and 1.2% of RIAs (second least common aneurysm location; OR 0.07 (95% CI 0.02 to 0.23), P<0.0001). Conclusions Ophthalmic aneurysms seem to have a low risk of rupture compared with other intracranial aneurysm locations. This calls for a re-evaluation of the benefit-risk balance when considering preventive treatment for ophthalmic aneurysms. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Childhood stroke

Author

Sporns, Peter B., Fullerton, Heather J., Lee, Sarah, Kim, Helen, Lo, Warren D., Mackay, Mark T., and Wildgruber, Moritz

Published
2022
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19. Mechanical Thrombectomy Versus Best Medical Treatment in the Late Time Window in Non-DEFUSE-Non-DAWN Patients: A Multicenter Cohort Study

Author

Dittrich, Tolga D., Sporns, Peter B., Kriemler, Lilian F., Rudin, Salome, Nguyen, Anh, Zietz, Annaelle, Polymeris, Alexandros A., Tränka, Christopher, Thilemann, Sebastian, Wagner, Benjamin, Altersberger, Valerian L., Piot, Ines, Barinka, Filip, Müller, Susanne, Hänsel, Martin, Gensicke, Henrik, Engelter, Stefan T., Lyrer, Philippe A., Sutter, Raoul, Nickel, Christian H., Katan, Mira, Peters, Nils, Kulcsár, Zsolt, Karwacki, Grzegorz M., Pileggi, Marco, Cereda, Carlo, Wegener, Susanne, Bonati, Leo H., Fischer, Urs, Psychogios, Marios, and De Marchis, Gian Marco

Published
2023
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21. Automated Perfusion Calculations vs. Visual Scoring of Collaterals and CBV-ASPECTS: Has the Machine Surpassed the Eye?

Author

Psychogios, Marios-Nikos, Sporns, Peter B., Ospel, Johanna, Katsanos, Aristeidis H., Kabiri, Reza, Flottmann, Fabian A., Menon, Bijoy K., Horn, Mackenzie, Liebeskind, David S., Honda, Tristan, Ribo, Marc, Ruiz, Manuel Requena, Kabbasch, Christoph, Lichtenstein, Thorsten, Maurer, Christoph J., Berlis, Ansgar, Hellstern, Victoria, Henkes, Hans, Möhlenbruch, Markus A., Seker, Fatih, Ernst, Marielle S., Liman, Jan, Tsivgoulis, Georgios, and Brehm, Alex

Published
2021
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25. Cerebrovascular Collateral Integrity in Pediatric Large Vessel Occlusion: Analysis of the Save ChildS Study

Author

Lee, Sarah, Jiang, Bin, Wintermark, Max, Mlynash, Michael, Christensen, Soren, Sträter, Ronald, Broocks, Gabriel, Grams, Astrid, Dorn, Franziska, Nikoubashman, Omid, Kaiser, Daniel, Morotti, Andrea, Jensen-Kondering, Ulf, Trenkler, Johannes, Möhlenbruch, Markus, Fiehler, Jens, Wildgruber, Moritz, Kemmling, André, Psychogios, Marios, and Sporns, Peter B.

Published
2022
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26. Diagnosis and endovascular management of vasospasm after aneurysmal subarachnoid hemorrhage -- survey of real-life practices.

Author

Guenego, Adrien, Fahed, Robert, Rouchaud, Aymeric, Walker, Gregory, Faizy, Tobias D., Sporns, Peter B., Aggour, Mohamed, Jabbour, Pascal, Alexandre, Andrea M., Mosimann, Pascal John, Dmytriw, Adam A., Ligot, Noémie, Sadeghi, Niloufar, Chengbo Dai, Hassan, Ameer E., Pereira, Vitor M., Singer, Justin, Heit, Jeremy J., Taccone, Fabio Silvio, and Chen, Michael

Subjects
INTRACRANIAL aneurysms, NIMODIPINE, CEREBRAL vasospasm, NEUROLOGISTS, SUBARACHNOID hemorrhage, QUESTIONNAIRES, ANGIOPLASTY, ENDOVASCULAR surgery, DESCRIPTIVE statistics, TRANSCRANIAL Doppler ultrasonography, PHYSICIAN practice patterns, DISEASE complications
Abstract

Background Vasospasm and delayed cerebral ischemia (DCI) are the leading causes of morbidity and mortality after intracranial aneurysmal subarachnoid hemorrhage (aSAH). Vasospasm detection, prevention and management, especially endovascular management varies from center to center and lacks standardization. We aimed to evaluate this variability via an international survey of how neurointerventionalists approach vasospasm diagnosis and endovascular management. Methods We designed an anonymous online survey with 100 questions to evaluate practice patterns between December 2021 and September 2022. We contacted endovascular neurosurgeons, neuroradiologists and neurologists via email and via two professional societies -- the Society of NeuroInterventional Surgery (SNIS) and the European Society of Minimally Invasive Neurological Therapy (ESMINT). We recorded the physicians' responses to the survey questions. Results A total of 201 physicians (25% [50/201] USA and 75% non-USA) completed the survey over 10 months, 42% had >7 years of experience, 92% were male, median age was 40 (IQR 35-46). Both high-volume and low- volume centers were represented. Daily transcranial Doppler was the most common screening method (75%) for vasospasm. In cases of symptomatic vasospasm despite optimal medical management, endovascular treatment was directly considered by 58% of physicians. The most common reason to initiate endovascular treatment was clinical deficits associated with proven vasospasm/DCI in 89%. The choice of endovascular treatment and its efficacy was highly variable. Nimodipine was the most common first- line intra-arterial therapy (40%). Mechanical angioplasty was considered the most effective endovascular treatment by 65% of neurointerventionalists. Conclusion Our study highlights the considerable heterogeneity among the neurointerventional community regarding vasospasm diagnosis and endovascular management. Randomized trials and guidelines are needed to improve standard of care, determine optimal management approaches and track outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Clinical diffusion mismatch to select pediatric patients for embolectomy 6 to 24 hours after stroke: An analysis of the Save ChildS Study

Author

Sporns, Peter B., Psychogios, Marios-Nikos, Straeter, Ronald, Hanning, Uta, Minnerup, Jens, Chapot, René, Henkes, Hans, Henkes, Elina, Grams, Astrid, Dorn, Franziska, Nikoubashman, Omid, Wiesmann, Martin, Bier, Georg, Weber, Anushe, Broocks, Gabriel, Fiehler, Jens, Brehm, Alex, Kaiser, Daniel, Yilmaz, Umut, Morotti, Andrea, Marik, Wolfgang, Nolz, Richard, Jensen-Kondering, Ulf, Braun, Michael, Schob, Stefan, Beuing, Oliver, Goetz, Friedrich, Trenkler, Johannes, Turowski, Bernd, Möhlenbruch, Markus, Wendl, Christina, Schramm, Peter, Musolino, Patricia L., Lee, Sarah, Schlamann, Marc, Radbruch, Alexander, Karch, André, Rübsamen, Nicole, Wildgruber, Moritz, and Kemmling, André

Published
2020
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29. Effect of Pre- and In-Hospital Delay on Reperfusion in Acute Ischemic Stroke Mechanical Thrombectomy

Author

Kaesmacher, Johannes, Maamari, Basel, Meinel, Thomas R., Piechowiak, Eike I., Mosimann, Pascal J., Mordasini, Pasquale, Goeldlin, Martina, Arnold, Marcel, Dobrocky, Tomas, Boeckh-Behrens, Tobias, Berndt, Maria, Michel, Patrik, Requena, Manuel, Benali, Amel, Pierot, Laurent, Mendes Pereira, Vitor, Boulouis, Grégoire, Brehm, Alex, Sporns, Peter B., Ospel, Johanna M., Gralla, Jan, and Fischer, Urs

Published
2020
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30. Does Device Selection Impact Recanalization Rate and Neurological Outcome?: An Analysis of the Save ChildS Study

Author

Sporns, Peter B., Straeter, Ronald, Minnerup, Jens, Wiendl, Heinz, Hanning, Uta, Chapot, René, Henkes, Hans, Henkes, Elina, Grams, Astrid, Dorn, Franziska, Nikoubashman, Omid, Wiesmann, Martin, Bier, Georg, Weber, Anushe, Broocks, Gabriel, Fiehler, Jens, Brehm, Alex, Psychogios, Marios, Kaiser, Daniel, Yilmaz, Umut, Morotti, Andrea, Marik, Wolfgang, Nolz, Richard, Jensen-Kondering, Ulf, Schmitz, Bernd, Schob, Stefan, Beuing, Oliver, Goetz, Friedrich, Trenkler, Johannes, Turowski, Bernd, Möhlenbruch, Markus, Wendl, Christina, Schramm, Peter, Musolino, Patricia, Lee, Sarah, Schlamann, Marc, Radbruch, Alexander, Rübsamen, Nicole, Karch, André, Heindel, Walter, Wildgruber, Moritz, and Kemmling, André

Published
2020
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34. Effect of anesthetic strategies on distal stroke thrombectomy in the anterior and posterior cerebral artery.

Author

Meyer, Lukas, Stracke, Christian Paul, Broocks, Gabriel, Wallocha, Marta, Elsharkawy, Mohamed, Sporns, Peter B., Piechowiak, Eike I., Kaesmacher, Johannes, and Maegerlein, Christian

Subjects
INTRACRANIAL hemorrhage, CONSCIOUS sedation, PATIENT safety, LOCAL anesthesia, ANTERIOR cerebral artery, TREATMENT effectiveness, RETROSPECTIVE studies, DESCRIPTIVE statistics, POSTERIOR cerebral artery, ANESTHETICS, THROMBECTOMY, STROKE, COMPARATIVE studies, GENERAL anesthesia
Abstract

Background Numerous questions regarding procedural details of distal stroke thrombectomy remain unanswered. This study assesses the effect of anesthetic strategies on procedural, clinical and safety outcomes following thrombectomy for distal medium vessel occlusions (DMVOs). Methods Patients with isolated DMVO stroke from the TOPMOST registry were analyzed with regard to anesthetic strategies (ie, conscious sedation (CS), local (LA) or general anesthesia (GA)). Occlusions were in the P2/P3 or A2-A4 segments of the posterior and anterior cerebral arteries (PCA and ACA), respectively. The primary endpoint was the rate of complete reperfusion (modified Thrombolysis in Cerebral Infarction score 3) and the secondary endpoint was the rate of modified Rankin Scale score 0-1. Safety endpoints were the occurrence of symptomatic intracranial hemorrhage and mortality. Results Overall, 233 patients were included. The median age was 75 years (range 64-82), 50.6% (n=118) were female, and the baseline National Institutes of Health Stroke Scale score was 8 (IQR 4-12). DMVOs were in the PCA in 59.7% (n=139) and in the ACA in 40.3% (n=94). Thrombectomy was performed under LA±CS (51.1%, n=119) and GA (48.9%, n=114). Complete reperfusion was reached in 73.9% (n=88) and 71.9% (n=82) in the LA±CS and GA groups, respectively (P=0.729). In subgroup analysis, thrombectomy for ACA DMVO favored GA over LA±CS (aOR 3.07, 95% CI 1.24 to 7.57, P=0.015). Rates of secondary and safety outcomes were similar in the LA±CS and GA groups. Conclusion LA±CS compared with GA resulted in similar reperfusion rates after thrombectomy for DMVO stroke of the ACA and PCA. GA may facilitate achieving complete reperfusion in DMVO stroke of the ACA. Safety and functional long-term outcomes were comparable in both groups. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Rescue intracranial permanent stenting for refractory occlusion following thrombectomy: a propensity matched analysis.

Author

Ifergan, Heloise, Dargazanli, Cyril, Hassen, Wagih Ben, Hak, Jean-Francois, Gory, Benjamin, Ognard, Julien, Premat, Kevin, Marnat, Gaultier, Kerleroux, Basile, Zhu, François, Bellanger, Guillaume, Sporns, Peter B., Charbonnier, Guillaume, Forestier, Géraud, Caroff, Jildaz, Fauché, Cédric, Clarençon, Frédéric, Janot, Kevin, Lapergue, Bertrand, and Boulouis, Gregoire

Subjects
ARTERIAL occlusions, RESEARCH, CEREBRAL hemorrhage, COMBINATION drug therapy, CONFIDENCE intervals, CEREBRAL infarction, INTRACRANIAL arterial diseases, SURGICAL stents, RETROSPECTIVE studies, ACQUISITION of data, TREATMENT effectiveness, HOSPITAL mortality, THROMBECTOMY, STROKE patients, MEDICAL records, DESCRIPTIVE statistics, PLATELET aggregation inhibitors, ODDS ratio, PATIENT safety, LONGITUDINAL method, EVALUATION
Abstract

Background Rescue intracranial stenting (RIS) can be used in refractory large vessel occlusion (LVO) after mechanical thrombectomy (MT). We aimed to assess the safety and efficacy of RIS versus a propensity matched sample of patients with persistent LVO. Methods We retrospectively analysed a multicenter retrospective pooled cohort of patients with anterior LVO (2015-2021) treated with MT, and identified patients with at least three passes and a modified Thrombolysis In Cerebral Infarction (mTICI) score of 0 to 2a. Propensity score matching was used to account for determinants of outcome in patients with or without RIS. The study outcomes included 3 months modified Rankin Scale (mRS) and symptomatic hemorrhagic transformation (HT). Results 420 patients with a refractory anterior occlusion were included, of which 101 were treated with RIS (mean age 69 years). Favorable outcome (mRS 0-2) was more frequent in patients with a patent stent at day 1 (53% vs 6%, P<0.001), which was independently associated with an early dual antiplatelet regimen (P<0.05). In the propensity matched sample, patients treated with RIS versus without RIS had similar rates of favorable outcomes (36.8% vs 30.3%, P=0.606). Patients with RIS showed a favorable shift in the overall mRS distributions (common adjusted OR 0.74, 95% CI 0.60 to 0.91, P=0.006). Symptomatic HT was marginally more frequent in the RIS group (9% vs 3%, P=0.07), and there was no difference in 3-month mortality. Conclusion In selected patients with a refractory intracranial occlusion despite at least three thrombectomy passes, RIS may be associated with an overall shift towards more favorable clinical outcome, and no significant increase in the odds of symptomatic HT or death. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Unfavorable Cerebral Venous Outflow is associated with Futile Recanalization in Acute Ischemic Stroke Patients

Author

Heitkamp, Christian, primary, Winkelmeier, Laurens, additional, Heit, Jeremy J., additional, Albers, Gregory W., additional, Lansberg, Maarten G., additional, Wintermark, Max, additional, Broocks, Gabriel, additional, van Horn, Noel, additional, Kniep, Helge C., additional, Sporns, Peter B., additional, Zeleňák, Kamil, additional, Fiehler, Jens, additional, and Faizy, Tobias D., additional

Published
2023
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42. Effect of anesthetic strategies on distal stroke thrombectomy in the anterior and posterior cerebral artery

Author

Meyer, Lukas, primary, Stracke, Christian Paul, additional, Broocks, Gabriel, additional, Wallocha, Marta, additional, Elsharkawy, Mohamed, additional, Sporns, Peter B, additional, Piechowiak, Eike I, additional, Kaesmacher, Johannes, additional, Maegerlein, Christian, additional, Hernandez Petzsche, Moritz Roman, additional, Zimmermann, Hanna, additional, Naziri, Weis, additional, Abdullayev, Nuran, additional, Kabbasch, Christoph, additional, Behme, Daniel, additional, Thormann, Maximilian, additional, Maus, Volker, additional, Fischer, Sebastian, additional, Möhlenbruch, Markus A, additional, Weyland, Charlotte Sabine, additional, Langner, Soenke, additional, Ernst, Marielle, additional, Jamous, Ala, additional, Meila, Dan, additional, Miszczuk, Milena, additional, Siebert, Eberhard, additional, Lowens, Stephan, additional, Krause, Lars Udo, additional, Yeo, Leonard LL, additional, Tan, Benjamin Y Q, additional, Gopinathan, Anil, additional, Gory, Benjamin, additional, Galvan Fernandez, Jorge, additional, Schüller Arteaga, Miguel, additional, Navia, Pedro, additional, Raz, Eytan, additional, Shapiro, Maksim, additional, Arnberg, Fabian, additional, Zeleňák, Kamil, additional, Martínez-Galdámez, Mario, additional, Alexandrou, Maria, additional, Kastrup, Andreas, additional, Papanagiotou, Panagiotis, additional, Dorn, Franziska, additional, Kemmling, André, additional, Psychogios, Marios-Nikos, additional, Andersson, Tommy, additional, Chapot, René, additional, Fiehler, Jens, additional, and Hanning, Uta, additional

Published
2023
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49. Mechanical Thrombectomy Versus Best Medical Treatment in the Late Time Window in Non-DEFUSE-Non-DAWN Patients: A Multicenter Cohort Study

Author

Dittrich, Tolga D; https://orcid.org/0000-0002-9987-3631, Sporns, Peter B; https://orcid.org/0000-0002-3028-0539, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh; https://orcid.org/0000-0002-9343-8276, Zietz, Annaelle; https://orcid.org/0000-0002-4362-2497, Polymeris, Alexandros A; https://orcid.org/0000-0002-9475-2208, Tränka, Christopher, Thilemann, Sebastian; https://orcid.org/0000-0002-2735-0794, Wagner, Benjamin; https://orcid.org/0000-0001-9330-1790, Altersberger, Valerian L; https://orcid.org/0000-0002-0610-9328, Piot, Ines; https://orcid.org/0000-0001-8502-7453, Barinka, Filip; https://orcid.org/0000-0002-5823-0656, Müller, Susanne; https://orcid.org/0000-0002-5638-722X, Hänsel, Martin; https://orcid.org/0000-0001-9300-1130, Gensicke, Henrik; https://orcid.org/0000-0002-0949-2422, Engelter, Stefan T; https://orcid.org/0000-0003-3855-6234, Lyrer, Philippe A; https://orcid.org/0000-0002-1435-1114, Sutter, Raoul; https://orcid.org/0000-0002-6575-356X, Nickel, Christian H, Katan, Mira; https://orcid.org/0000-0002-9265-8066, Peters, Nils, Kulcsár, Zsolt; https://orcid.org/0000-0002-6805-5150, Karwacki, Grzegorz M; https://orcid.org/0000-0001-5963-6220, Pileggi, Marco; https://orcid.org/0000-0002-7691-8999, Cereda, Carlo; https://orcid.org/0000-0002-6479-1476, Wegener, Susanne; https://orcid.org/0000-0003-4369-7023, Bonati, Leo H; https://orcid.org/0000-0003-1163-8133, Fischer, Urs; https://orcid.org/0000-0003-0521-4051, Psychogios, Marios; https://orcid.org/0000-0002-0016-414X, et al, Dittrich, Tolga D; https://orcid.org/0000-0002-9987-3631, Sporns, Peter B; https://orcid.org/0000-0002-3028-0539, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh; https://orcid.org/0000-0002-9343-8276, Zietz, Annaelle; https://orcid.org/0000-0002-4362-2497, Polymeris, Alexandros A; https://orcid.org/0000-0002-9475-2208, Tränka, Christopher, Thilemann, Sebastian; https://orcid.org/0000-0002-2735-0794, Wagner, Benjamin; https://orcid.org/0000-0001-9330-1790, Altersberger, Valerian L; https://orcid.org/0000-0002-0610-9328, Piot, Ines; https://orcid.org/0000-0001-8502-7453, Barinka, Filip; https://orcid.org/0000-0002-5823-0656, Müller, Susanne; https://orcid.org/0000-0002-5638-722X, Hänsel, Martin; https://orcid.org/0000-0001-9300-1130, Gensicke, Henrik; https://orcid.org/0000-0002-0949-2422, Engelter, Stefan T; https://orcid.org/0000-0003-3855-6234, Lyrer, Philippe A; https://orcid.org/0000-0002-1435-1114, Sutter, Raoul; https://orcid.org/0000-0002-6575-356X, Nickel, Christian H, Katan, Mira; https://orcid.org/0000-0002-9265-8066, Peters, Nils, Kulcsár, Zsolt; https://orcid.org/0000-0002-6805-5150, Karwacki, Grzegorz M; https://orcid.org/0000-0001-5963-6220, Pileggi, Marco; https://orcid.org/0000-0002-7691-8999, Cereda, Carlo; https://orcid.org/0000-0002-6479-1476, Wegener, Susanne; https://orcid.org/0000-0003-4369-7023, Bonati, Leo H; https://orcid.org/0000-0003-1163-8133, Fischer, Urs; https://orcid.org/0000-0003-0521-4051, Psychogios, Marios; https://orcid.org/0000-0002-0016-414X, and et al

Abstract

Background: We assessed the efficacy and safety of mechanical thrombectomy (MT) in adult stroke patients with anterior circulation large vessel occlusion presenting in the late time window not fulfilling the DEFUSE-3 (Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging trial) and DAWN (Thrombectomy 6 to 24 Hours After Stroke With a Mismatch Between Deficit and Infarct trial) inclusion criteria. Methods: Cohort study of adults with anterior circulation large vessel occlusion admitted between 6 and 24 hours after last-seen-well at 5 participating Swiss stroke centers between 2014 and 2021. Mismatch was assessed by computer tomography or magnetic resonance imaging perfusion with automated software (RAPID or OLEA). We excluded patients meeting DEFUSE-3 and DAWN inclusion criteria and compared those who underwent MT with those receiving best medical treatment alone by inverse probability of treatment weighting using the propensity score. The primary efficacy end point was a favorable functional outcome at 90 days, defined as a modified Rankin Scale score shift toward lower categories. The primary safety end point was symptomatic intracranial hemorrhage within 7 days of stroke onset; the secondary was all-cause mortality within 90 days. Results: Among 278 patients with anterior circulation large vessel occlusion presenting in the late time window, 190 (68%) did not meet the DEFUSE-3 and DAWN inclusion criteria and thus were included in the analyses. Of those, 102 (54%) received MT. In the inverse probability of treatment weighting analysis, patients in the MT group had higher odds of favorable outcomes compared with the best medical treatment alone group (modified Rankin Scale shift: acOR, 1.46 [1.02–2.10]; P=0.04) and lower odds of all-cause mortality within 90 days (aOR, 0.59 [0.37–0.93]; P=0.02). There were no significant differences in symptomatic intracranial hemorrhage (MT versus best medical treatment alone: 5% versus 2%, P=0.63). Conclusio

Published
2023

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