Endovascular thrombectomy of calcified emboli in acute ischemic stroke

• Verfasst von: Maurer, Christoph J. [VerfasserIn]
• Verfasst von: Dobrocky, T. [VerfasserIn]
• Verfasst von: Joachimski, F. [VerfasserIn]
• Verfasst von: Neuberger, Ulf [VerfasserIn]
• Verfasst von: Demerath, T. [VerfasserIn]
• Verfasst von: Brehm, A. [VerfasserIn]
• Verfasst von: Cianfoni, A. [VerfasserIn]
• Verfasst von: Gory, B. [VerfasserIn]
• Verfasst von: Berlis, A. [VerfasserIn]
• Verfasst von: Gralla, J. [VerfasserIn]
• Verfasst von: Möhlenbruch, Markus Alfred [VerfasserIn]
• Verfasst von: Blackham, K. A. [VerfasserIn]
• Verfasst von: Psychogios, M. N. [VerfasserIn]
• Verfasst von: Zickler, P. [VerfasserIn]
• Verfasst von: Fischer, S. [VerfasserIn]
• Titel: Endovascular thrombectomy of calcified emboli in acute ischemic stroke
• Titelzusatz: a multicenter study
• Verf.angabe: C.J. Maurer, T. Dobrocky, F. Joachimski, U. Neuberger, T. Demerath, A. Brehm, A. Cianfoni, B. Gory, A. Berlis, J. Gralla, M.A. Möhlenbruch, K.A. Blackham, M.N. Psychogios, P. Zickler, and S. Fischer
• E-Jahr: 2020
• Jahr: March 17, 2020
• Umfang: 5 S.
• Fussnoten: Gesehen am 30.04.2020
• Titel Quelle: Enthalten in: American journal of neuroradiology
• Ort Quelle: Oak Brook, Ill. : Soc., 1980
• Jahr Quelle: 2020
• Band/Heft Quelle: 41(2020), 3, Seite 464-468
• ISSN Quelle: 1936-959X
• DOI: doi:10.3174/ajnr.A6412
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1696968283

Abstract

Background and purpose: Large intracranial vessel occlusion due to calcified emboli is a rare cause of major stroke. We assessed the prevalence, imaging appearance, the effectiveness of mechanical thrombectomy, and clinical outcome of patients with large-vessel occlusion due to calcified emboli. - Materials and methods: We performed a retrospective analysis of clinical and procedural data of consecutive patients who underwent mechanical thrombectomy due to calcified emboli in 7 European stroke centers. - Results: We screened 2969 patients, and 40 patients matched the inclusion criteria, accounting for a prevalence of 1.3%. The mean maximal density of the thrombus was 327 HU (range, 150-1200 HU), and the mean thrombus length was 9.2 mm (range, 4-20 mm). Four patients had multiple calcified emboli, and 2 patients had an embolic event during an endovascular intervention. A modified TICI score of ≥2b was achieved in 57.5% (23/40), with minimal-to-no reperfusion (modified TICI 0-1) in 32.5% (13/40) and incomplete reperfusion (modified TICI 2a) in 10% (4/40). Excellent outcome (mRS 0-1) was achieved in only 20.6%, functional independence (mRS 0-2) in 26.5% and 90-day mortality was 55.9%. - Conclusions: Acute ischemic stroke with large-vessel occlusion due to calcified emboli is a rare entity in patients undergoing thrombectomy, with considerably worse angiographic outcome and a higher mortality compared with patients with noncalcified thrombi. Good functional recovery at 3 months can still be achieved in about a quarter of patients.