Number of Retrieval Attempts Rather Than Procedure Time Is Associated With Risk of Symptomatic Intracranial Hemorrhage

 

IT IS YOUR RESPONSIBILITY  to have the proper stroke that only needs one pass.  All because your doctors and stroke hospital have not taken the proper steps to create 100% recovery protocols for ANY situation. 

IT IS YOUR RESPONSIBILITY to ensure your hospital does create those protocols. Without your push your stroke hospital will do nothing.  If your want your children and grandchildren to 100% recover from a stroke YOU  have to start right now.

The latest here:

Number of Retrieval Attempts Rather Than Procedure Time Is Associated With Risk of Symptomatic Intracranial Hemorrhage

Máté Elöd Maros

,

Caspar Brekenfeld

,

Gabriel Broocks

,

Hannes Leischner

,

Rosalie McDonough

,

Milani Deb-Chatterji

,

Anna Alegiani

,

Götz Thomalla

,

Jens Fiehler

,

Fabian Flottmann

,

Originally published5 Apr 2021https://doi.org/10.1161/STROKEAHA.120.031242Stroke. ;0:STROKEAHA.120.031242

Abstract

Background and Purpose:

Endovascular therapy is the standard of care in the treatment of acute ischemic stroke due to large-vessel occlusion. A direct association between the number of device passes and the occurrence of symptomatic intracranial hemorrhage (SICH) has been suggested. This study represents an in-depth investigation of the hypothesis that >3 retrieval attempts is associated with an increased rate of SICH in a large multicenter patient cohort.

Methods:

Two thousand six hundred eleven patients from the prospective German Stroke Registry were analyzed. Patients who received Endovascular therapy for acute large-vessel occlusion of the anterior circulation with known admission National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score, final Thrombolysis in Cerebral Infarction, and number of retrieval passes were included. The primary outcome was defined as SICH. The secondary outcome was any type of radiologically confirmed intracranial hemorrhage within the first 24 hours. Multivariate mixed-effects models were used to adjust for cluster effects of the participating centers, as well as for confounders.

Results:

Five hundred ninety-three patients fulfilled the inclusion criteria. The median number of retrieval passes was 2 [interquartile range, 1–3]. SICH occurred in 26 cases (4.4%), whereas intracranial hemorrhage was identified by neuroimaging in 85 (14.3%) cases. More than 3 retrieval passes was the strongest predictor for SICH (odds ratio, 3.61 [95% CI, 1.38–9.42], P=0.0089) following adjustment for age, admission National Institutes of Health Stroke Scale, admission Alberta Stroke Program Early CT Score, and Thrombolysis in Cerebral Infarction, as well as time from symptom onset to flow restoration. Baseline Alberta Stroke Program Early CT Score of 8 to 9 (odds ratio, 0.26 [95% CI, 0.07–0.89], P=0.032) or 10 (odds ratio, 0.21 [95% CI, 0.06–0.78], P=0.020) were significant protective factors against the occurrence of SICH.

Conclusions:

More than 3 retrieval attempts is associated with a significant increase in SICH risk, regardless of patient age, baseline National Institutes of Health Stroke Scale, or procedure time. This should be considered when deciding whether to continue a procedure, especially in patients with large baseline infarctions.(So you are going to let 1.9 million neurons die per minute. Good to know the incompetence involved.)

REGISTRATION:

URL: https://www.clinicaltrials.gov; Unique identifier: NCT03356392.

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