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Safety and efficacy of mechanical thrombectomy in infective endocarditis : A matched case–control analysis from the German Stroke Registry–Endovascular Treatment
- Source :
- European journal of neurology 28(3), 861-867 (2021). doi:10.1111/ene.14686
- Publication Year :
- 2021
- Publisher :
- Wiley-Blackwell, 2021.
-
Abstract
- BACKGROUND AND PURPOSE Up to 30% of infective endocarditis (IE) patients have ischemic stroke as a complication. Standard treatment with mechanical thrombectomy (MT) with or without intravenous thrombolysis for large vessel occlusion (LVO) has not been evaluated formally in these patients. METHODS Patients enrolled in the German Stroke Registry-Endovascular Treatment (GSR-ET) between June 2015 and December 2019 were analyzed. Patients with stroke due to IE and patients with cardioembolic stroke and atrial fibrillation (AF) were compared using propensity score matching. Successful reperfusion was defined as modified Thrombolysis in Cerebral Infarction score = 2b-3. Modified Rankin Scale (mRS) = 0-2 at 3 months indicated good outcome. RESULTS Of 6635 patients, 55 patients (age = 69.0 ± 13.3 years, 43.6% female, median premorbid mRS (pmRS) = 1, interquartile range [IQR] = 0-1, National Institutes of Health Stroke Scale [NIHSS] = 15, IQR = 10-21) presented with septic embolic stroke due to IE and were compared to 104 patients (age = 66.5 ± 13.4 years, 39.4% female, pmRS = 0, IQR = 0-2, NIHSS = 16, IQR = 10-20) with cardioembolic stroke due to AF. Successful recanalization was achieved in 74.5% of endocarditis patients compared to 87.5% of controls (p = 0.039). Intracranial hemorrhage rates were comparable (30.9% vs. 21.6%, p = 0.175). Good functional outcome was 20.0% in patients with IE compared to 43.3% in matched patients (p = 0.006), with a significantly higher mortality (60.0% vs. 28.8%, p
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Brain Ischemia
03 medical and health sciences
0302 clinical medicine
Modified Rankin Scale
Interquartile range
Internal medicine
medicine
Endocarditis
Humans
030212 general & internal medicine
Registries
Stroke
Retrospective Studies
Thrombectomy
Cerebral infarction
business.industry
Standard treatment
Endovascular Procedures
Infant, Newborn
Infant
Atrial fibrillation
Thrombolysis
medicine.disease
Treatment Outcome
Neurology
Cardiology
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- European journal of neurology 28(3), 861-867 (2021). doi:10.1111/ene.14686
- Accession number :
- edsair.doi.dedup.....8587d3509ce7852376663461c4109162