Mechanical Thrombectomy for Patients with In-Hospital Ischemic Stroke: A Case-Control Study.

Title

Mechanical Thrombectomy for Patients with In-Hospital Ischemic Stroke: A Case-Control Study.

Creator

Bulwa Z; Del Brutto VJ; Loggini A; Ammar FE; Martinez RC; Christoforidis G; Brorson JR; Ardelt AA; Goldenberg FD

Publisher

Journal of Stroke and Cerebrovascular Diseases

Date

2020
2020-05

Description

BACKGROUND AND AIM: Patients with in-hospital acute ischemic stroke (AIS) have, in general, worse outcomes compared to those presenting from the community, partly attributed to the numerous contraindications to intravenous thrombolysis. We aimed to identify and analyze a group of patients with in-hospital AIS who remain suitable candidates for acute endovascular therapies. METHODS: A retrospective 6-year data analysis was conducted in patients evaluated through the in-hospital stroke alert protocol in a single tertiary care university hospital to identify those with in-hospital AIS due to acute intracranial large vessel occlusion (ILVO). Feasibility and safety of mechanical thrombectomy for in-hospital AIS was assessed in a case-control study comparing inpatients to those presenting from the community. RESULTS: From 1460 in-hospital stroke alert activations, 11% had a final diagnosis of AIS (n = 167). One hundred and two patients with in-hospital AIS had emergent intracranial vessel imaging and were included in our cohort. Acute ILVO was identified in 27 patients within this cohort. Patients were younger in the ILVO group and had more severe neurologic deficit on presentation. Compared to a matched (1:2) control group of patients presenting from the community, inpatients who underwent mechanical thrombectomy achieved equivalent technical success, safety, and clinical outcomes. CONCLUSIONS: The incidence of acute ILVO in patients with in-hospital AIS who underwent emergent vessel imaging is similar to the reported incidence of ILVO in patients presenting with community-onset AIS. Among patients with in-hospital AIS secondary to ILVO, mechanical thrombectomy is a feasible and safe therapy associated with favorable outcomes.

Subject

Aged; Humans; Male; Female; Middle Aged; Treatment Outcome; Time Factors; Feasibility Studies; Incidence; Retrospective Studies; thrombectomy; Inpatients; Thrombectomy/adverse effects; Acute ischemic stroke; Brain Ischemia/diagnostic imaging/epidemiology/physiopathology/therapy; in-hospital stroke; Intracranial Thrombosis/diagnostic imaging/epidemiology/physiopathology/therapy; large vessel occlusion; Stroke/diagnostic imaging/epidemiology/physiopathology/therapy

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

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Pages

104692

Issue

5

Volume

29

ISSN

1532-8511 1052-3057

Update Year & Number

Hospital List

Citation

Bulwa Z; Del Brutto VJ; Loggini A; Ammar FE; Martinez RC; Christoforidis G; Brorson JR; Ardelt AA; Goldenberg FD, “Mechanical Thrombectomy for Patients with In-Hospital Ischemic Stroke: A Case-Control Study.,” NEOMED Bibliography Database, accessed October 18, 2021, https://neomed.omeka.net/items/show/11415.

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