Clinical consequence of vessel perforations during endovascular treatment of acute ischemic stroke

被引:1
|
作者
van der Sluijs, P. Matthijs [1 ]
Su, R. [1 ]
Cornelissen, S. A. P. [1 ]
van Es, A. C. G. M. [2 ]
Nijeholt, G. Lycklama [3 ]
Roozenbeek, B. [4 ]
van Doormaal, P. J. [1 ]
Hofmeijer, J. [5 ,6 ]
van der Lugt, A. [1 ]
van Walsum, T. [1 ]
机构
[1] Erasmus MC Univ Med Ctr, Dept Radiol & Nucl Med, Rotterdam, Netherlands
[2] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands
[3] Haaglanden Med Ctr, Dept Radiol, The Hague, Netherlands
[4] Erasmus MC Univ Med Ctr, Dept Neurol, Rotterdam, Netherlands
[5] Rijnstate Hosp, Dept Neurol, Arnhem, Netherlands
[6] Univ Twente, Dept Clin Neurophysiol, Enschede, Netherlands
关键词
Ischemic stroke; Thrombectomy; Vessel perforation; Adverse effects; Complications; Determinants; INTRAVENOUS THROMBOLYSIS; RANDOMIZED-TRIAL; THROMBECTOMY; SEGMENT; WALL;
D O I
10.1007/s00234-023-03246-2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
PurposeEndovascular treatment (EVT) of acute ischemic stroke can be complicated by vessel perforation. We studied the incidence and determinants of vessel perforations. In addition, we studied the association of vessel perforations with functional outcome, and the association between location of perforation on digital subtraction angiography (DSA) and functional outcome, using a large EVT registry.MethodsWe included all patients in the MR CLEAN Registry who underwent EVT. We used DSA to determine whether EVT was complicated by a vessel perforation. We analyzed the association with baseline clinical and interventional parameters using logistic regression models. Functional outcome was measured using the modified Rankin Scale at 90 days. The association between vessel perforation and angiographic imaging features and functional outcome was studied using ordinal logistic regression models adjusted for prognostic parameters. These associations were expressed as adjusted common odds ratios (acOR).ResultsVessel perforation occurred in 74 (2.6%) of 2794 patients who underwent EVT. Female sex (aOR 2.0 (95% CI 1.2-3.2)) and distal occlusion locations (aOR 2.2 (95% CI 1.3-3.5)) were associated with increased risk of vessel perforation. Functional outcome was worse in patients with vessel perforation (acOR 0.38 (95% CI 0.23-0.63)) compared to patients without a vessel perforation. No significant association was found between location of perforation and functional outcome.ConclusionThe incidence of vessel perforation during EVT in this cohort was low, but has severe clinical consequences. Female patients and patients treated at distal occlusion locations are at higher risk.
引用
收藏
页码:237 / 247
页数:11
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