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1. International controlled study of revascularization and outcomes following COVID‐positive mechanical thrombectomy

Author

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, Naamani, Kareem El, Abbas, Rawad, Mansour, Ossama Y, Galvan, Jorge, Billingsley, Joshua T, Mortazavi, Abolghasem, Walker, Melanie, Dibas, Mahmoud, Settecase, Fabio, Heran, Manraj KS, 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, de la Ossa, Natalia Perez, 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, and Investigators, North American Neurovascular COVID‐19 Consortium Society of Vascular and Interventional Neurology

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Stroke, Clinical Research, Good Health and Well Being, Brain Ischemia, COVID-19, Cross-Sectional Studies, Endovascular Procedures, Humans, Male, Retrospective Studies, Thrombectomy, Treatment Outcome, large vessel occlusion, morbidity, mortality, stroke, North American Neurovascular COVID-19 (NAN-C) Consortium &amp, Society of Vascular and Interventional Neurology (SVIN) Investigators, Neurology & Neurosurgery, Clinical sciences
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

Published
2022

2. Characteristics of a COVID-19 Cohort With Large Vessel Occlusion: A Multicenter International Study

Author

Jabbour, Pascal, Dmytriw, Adam A, Sweid, Ahmad, Piotin, Michel, Bekelis, Kimon, Sourour, Nader, Raz, Eytan, 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, Frédéric, Elhorany, Mahmoud, Vela-Duarte, Daniel, Tahir, Rizwan A, Youssef, Patrick P, Pandey, Aditya S, Starke, Robert M, Naamani, Kareem El, Abbas, Rawad, Hammoud, Bassel, Mansour, Ossama Y, Galvan, Jorge, Billingsley, Joshua T, Mortazavi, Abolghasem, Walker, Melanie, Dibas, Mahmoud, Settecase, Fabio, Heran, Manraj KS, Kuhn, Anna L, Puri, Ajit S, Menon, Bijoy K, Sivakumar, Sanjeev, Mowla, Ashkan, D'Amato, Salvatore, Zha, Alicia M, Cooke, Daniel, Goyal, Mayank, Wu, Hannah, Cohen, Jake, Turkel-Parrella, David, Xavier, Andrew, Waqas, Muhammad, Tutino, Vincent M, Siddiqui, Adnan, Gupta, Gaurav, Nanda, Anil, Khandelwal, Priyank, Tiu, Cristina, Portela, Pere C, de la Ossa, Natalia Perez, Urra, Xabier, de Lera, Mercedes, Arenillas, Juan F, Ribo, Marc, Requena, Manuel, Piano, Mariangela, Pero, Guglielmo, De Sousa, Keith, Al-Mufti, Fawaz, Hashim, Zafar, Nayak, Sanjeev, Renieri, Leonardo, Aziz-Sultan, Mohamed A, Nguyen, Thanh N, Feineigle, Patricia, Patel, Aman B, Siegler, James E, Badih, Khodr, Grossberg, Jonathan A, Saad, Hassan, Gooch, M Reid, Herial, Nabeel A, Rosenwasser, Robert H, Tjoumakaris, Stavropoula, and Tiwari, Ambooj

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Clinical Research, Brain Disorders, Stroke, Good Health and Well Being, Brain Ischemia, COVID-19, Cerebral Infarction, Humans, Retrospective Studies, Thrombectomy, Treatment Outcome, SARS-CoV-2, Central nervous system, Cerebrovascular disease, Hypercoagulable, Neurology & Neurosurgery, Clinical sciences, Biological psychology
Abstract

BackgroundThe mechanisms and outcomes in coronavirus disease (COVID-19)-associated stroke are unique from those of non-COVID-19 stroke.ObjectiveTo describe the efficacy and outcomes of acute revascularization of large vessel occlusion (LVO) in the setting of COVID-19 in an international cohort.MethodsWe conducted an international multicenter retrospective study of consecutively admitted patients with COVID-19 with concomitant acute LVO across 50 comprehensive stroke centers. Our control group constituted historical controls of patients presenting with LVO and receiving a mechanical thrombectomy between January 2018 and December 2020.ResultsThe total cohort was 575 patients with acute LVO; 194 patients had COVID-19 while 381 patients did not. Patients in the COVID-19 group were younger (62.5 vs 71.2; P < .001) and lacked vascular risk factors (49, 25.3% vs 54, 14.2%; P = .001). Modified thrombolysis in cerebral infarction 3 revascularization was less common in the COVID-19 group (74, 39.2% vs 252, 67.2%; P < .001). Poor functional outcome at discharge (defined as modified Ranklin Scale 3-6) was more common in the COVID-19 group (150, 79.8% vs 132, 66.7%; P = .004). COVID-19 was independently associated with a lower likelihood of achieving modified thrombolysis in cerebral infarction 3 (odds ratio [OR]: 0.4, 95% CI: 0.2-0.7; P < .001) and unfavorable outcomes (OR: 2.5, 95% CI: 1.4-4.5; P = .002).ConclusionCOVID-19 was an independent predictor of incomplete revascularization and poor outcomes in patients with stroke due to LVO. Patients with COVID-19 with LVO were younger, had fewer cerebrovascular risk factors, and suffered from higher morbidity/mortality rates.

Published
2022

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