International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy
Dmytriw, Adam A.; Ghozy, Sherief; Sweid, Ahmad; Piotin, Michel; Bekelis, Kimon; Sourour, Nader; Raz, Eytan; Vela-Duarte, Daniel; Linfante, Italo; Dabus, Guilherme; Kole, Max; Martínez-Galdámez, Mario; Nimjee, Shahid M.; Lopes, Demetrius K.; Hassan, Ameer E.; Kan, Peter; Ghorbani, Mohammad; Levitt, Michael R.; Escalard, Simon; Missios, Symeon; Shapiro, Maksim; Clarençon, Fréderic; Elhorany, Mahmoud; Tahir, Rizwan A.; Youssef, Patrick P.; Pandey, Aditya S.; Starke, Robert M.; El Naamani, Kareem; Abbas, Rawad; Mansour, Ossama Y.; Galvan, Jorge; Billingsley, Joshua T.; Mortazavi, Abolghasem; Walker, Melanie; Dibas, Mahmoud; Settecase, Fabio; Heran, Manraj K. S.; Kuhn, Anna L.; Puri, Ajit S.; Menon, Bijoy K.; Sivakumar, Sanjeev; Mowla, Ashkan; D’Amato, Salvatore; Zha, Alicia M.; Cooke, Daniel; Vranic, Justin E.; Regenhardt, Robert W.; Rabinov, James D.; Stapleton, Christopher J.; Goyal, Mayank; Wu, Hannah; Cohen, Jake; Turkel-Parella, David; Xavier, Andrew; Waqas, Muhammad; Tutino, Vincent; Siddiqui, Adnan; Gupta, Gaurav; Nanda, Anil; Khandelwal, Priyank; Tiu, Cristina; Portela, Pere C.; Perez de la Ossa, Natalia; Urra, Xabier; Lera, Mercedes; Arenillas, Juan F.; Ribo, Marc; Requena, Manuel; Piano, Mariangela; Pero, Guglielmo; Sousa, Keith; Al-Mufti, Fawaz; Hashim, Zafar; Nayak, Sanjeev; Renieri, Leonardo; Du, Rose; Aziz-Sultan, Mohamed A.; Liebeskind, David; Nogueira, Raul G.; Abdalkader, Mohamad; Nguyen, Thanh N.; Vigilante, Nicholas; Siegler, James E.; Grossberg, Jonathan A.; Saad, Hassan; Gooch, Michael R.; Herial, Nabeel A.; Rosenwasser, Robert H.; Tjoumakaris, Stavropoula; Patel, Aman B.; Tiwari, Ambooj; Jabbour, Pascal
2022-11
Citation
Dmytriw, Adam A.; Ghozy, Sherief; Sweid, Ahmad; Piotin, Michel; Bekelis, Kimon; Sourour, Nader; Raz, Eytan; Vela-Duarte, Daniel ; Linfante, Italo; Dabus, Guilherme; Kole, Max; Martínez-Galdámez, Mario ; Nimjee, Shahid M.; Lopes, Demetrius K.; Hassan, Ameer E.; Kan, Peter; Ghorbani, Mohammad; Levitt, Michael R.; Escalard, Simon; Missios, Symeon; Shapiro, Maksim; Clarençon, Fréderic ; Elhorany, Mahmoud; Tahir, Rizwan A.; Youssef, Patrick P.; Pandey, Aditya S.; Starke, Robert M.; El Naamani, Kareem; Abbas, Rawad; Mansour, Ossama Y.; Galvan, Jorge; Billingsley, Joshua T.; Mortazavi, Abolghasem; Walker, Melanie; Dibas, Mahmoud; Settecase, Fabio; Heran, Manraj K. S.; Kuhn, Anna L.; Puri, Ajit S.; Menon, Bijoy K.; Sivakumar, Sanjeev; Mowla, Ashkan; D’Amato, Salvatore; Zha, Alicia M.; Cooke, Daniel; Vranic, Justin E.; Regenhardt, Robert W.; Rabinov, James D.; Stapleton, Christopher J.; Goyal, Mayank; Wu, Hannah; Cohen, Jake; Turkel-Parella, David ; Xavier, Andrew; Waqas, Muhammad; Tutino, Vincent; Siddiqui, Adnan; Gupta, Gaurav; Nanda, Anil; Khandelwal, Priyank; Tiu, Cristina; Portela, Pere C.; Perez de la Ossa, Natalia; Urra, Xabier; Lera, Mercedes; Arenillas, Juan F.; Ribo, Marc; Requena, Manuel; Piano, Mariangela; Pero, Guglielmo; Sousa, Keith; Al-Mufti, Fawaz ; Hashim, Zafar; Nayak, Sanjeev; Renieri, Leonardo; Du, Rose; Aziz-Sultan, Mohamed A. ; Liebeskind, David; Nogueira, Raul G.; Abdalkader, Mohamad; Nguyen, Thanh N.; Vigilante, Nicholas; Siegler, James E.; Grossberg, Jonathan A.; Saad, Hassan; Gooch, Michael R.; Herial, Nabeel A.; Rosenwasser, Robert H.; Tjoumakaris, Stavropoula; Patel, Aman B.; Tiwari, Ambooj; Jabbour, Pascal (2022). "International controlled study of revascularization and outcomes following COVID- positive mechanical thrombectomy." European Journal of Neurology (11): 3273-3287.
Abstract
Background and purposePrevious 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.MethodsA 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.ResultsIn 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).ConclusionCOVID-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.We conducted a cross-sectional, international multicenter retrospective study of consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Our results shows that COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. In addition, COVID-19 patients with LVO were more often younger and suffered higher morbidity/mortality rates.Publisher
Wiley Periodicals, Inc.
ISSN
1351-5101 1468-1331
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