Risk factors for the development of embolism to a new territory after endovascular stroke treatment


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Görgülü Ü., aykaç ö., Uysal kocabaş z., GER AKARSU F., Dogan B., YILMAZ E., ...More

Türk Beyin Damar Hastalıkları Dergisi, vol.29, no.2, pp.89-96, 2023 (Peer-Reviewed Journal) identifier

Abstract

INTRODUCTION: The development of embolism to a new site (ENT) is an important complication in the endovascular treatment (EVT) of acute stroke and is associated with a poor outcome. The aim of our study was to investigate risk factors for the development of ENT. METHODS: Prospectively recorded files of patients who underwent EVT for acute stroke between 2015 and 2023 were reviewed. ENT development, demographic data, vascular risk factors, clinical findings, IV thrombolysis treatment at admission, EVT procedure modalities such as duration of the procedure, mechanical thrombectomy techniques including the use of stent retriever, balloon guiding catheter, and prognoses were evaluated for all patients. RESULTS: This study included 235 patients: 23 (9.8%) and 212 patients (90.2%) in the ENT group and non-ENT group, respectively. When comparing the case characteristic data of the two groups, the door-to-groin puncture (p=0.045) and groin puncture-to-recanalisation (p<0.001) times were longer, and the number of device passes (p<0.001) and symptomatic intracranial cerebral haemorrhage (sICH; p=0.049) increased in the ENT group. The number of device passes (OR=1.555; 95% CI 1.193–2.027; p=0.001) and and door-to-groin puncture time (OR=1.012; 95% CI 1.000–1.025; p=0.034) were identified as independent risk factors for the development of ENT. DISCUSSION AND CONCLUSION: ENT development after EVT of acute stroke is not uncommon and results in prolongation of procedure times. The number of device passes and longer door-to-groin puncture time are risk factors associated with ENT.