RT Journal Article
SR Electronic
T1 P137/17  Incidence and outcome of perforations occuring during Medium-Vessel Occlusion thrombectomy compared to Large-Vessel occlusion thrombectomy
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP A67
OP A67
DO 10.1136/jnis-2023-ESMINT.165
VO 15
IS Suppl 2
A1 Schulze-Zachau, Victor
A1 Brehm, Alex
A1 Ntoulias, Nikolaos
A1 Krug, Nadja
A1 Tsogkas, Ioannis
A1 Blackham, Kristine
A1 Möhlenbruch, Markus
A1 Jesser, Jessica
A1 Cervo, Amedeo
A1 Kreiser, Kornelia
A1 Althaus, Katharina
A1 Maslias, Errikos
A1 Michel, Patrik
A1 Saliou, Guillaume
A1 Riegler, Christoph
A1 Nolte, Christian
A1 Maier, Ilko
A1 Jamous, Ala
A1 Rautio, Riitta
A1 Ylikotila, Pauli
A1 Fargen, Kyle
A1 Wolfe, Stacey
A1 Castellano, Davide
A1 Boghi, Andrea
A1 Kaiser, Daniel
A1 Cuberi, Ani
A1 Kirschke, Jan
A1 Schwarting, Julian
A1 Limbucci, Nicola
A1 Renieri, Leonardo
A1 Kasab, Sami Al
A1 Spiotta, Alejandro
A1 Fragata, Isabel
A1 Rodríguez-Ares, Tania
A1 Maurer, Christoph
A1 Ansgar, Berlis
A1 Moreu, Manuel
A1 López-Jurado, Alfonso López-Frías
A1 Pérez-García, Carlos
A1 Commodaro, Christian
A1 Pileggi, Marco
A1 Mascitelli, Justin
A1 Giordano, Flavio
A1 Casagrande, Walter
A1 Purves, Cynthia
A1 Bester, Maxim
A1 Flottmann, Fabian
A1 Kan, Peter
A1 Edhayan, Gautam
A1 Hofmeister, Jeremy
A1 Machi, Paolo
A1 Kaschner, Marius
A1 Weiss, Daniel
A1 Katan, Mira
A1 Fischer, Urs
A1 Psychogios, Marios
YR 2023
UL http://jnis.bmj.com/content/15/Suppl_2/A67.1.abstract
AB Introduction Vessel perforation during thrombectomy is a severe complication and is hypothesized to be more frequent during MeVO compared to LVO thrombectomy.Aim of the study To compare the incidence and outcome of patients with perforation during MeVO and LVO thrombectomy and to report on the procedural steps that led to perforation.Methods In this multicenter retrospective cohort study, data of consecutive patients with vessel perforation during thrombectomy between January 01, 2015 and September 30, 2022 were collected. The primary outcomes were independent functional outcome (i.e. modified Rankin Scale 0–2) and all-cause mortality at 90 days. Binomial test, chi-squared test and t-test for unpaired samples were used for statistical analysis.Results During 25,769 thrombectomies (5,124 MeVO, 20,645 LVO) in 25 stroke centers, perforation occurred in 335 patients (1.3%; mean age 72 years, 62% female). Perforation occurred more often in MeVO thrombectomy (2.4%) than in LVO thrombectomy (1.0%, p < 0.001). More MeVO than LVO patients with perforation achieved functional independence at three months (25.7% vs 10.9%; p=0.001). All-cause mortality did not differ (overall 51.6%). Navigation beyond the occlusion and retraction of stent-retriever/aspiration catheter were the two most common procedural steps that led to perforation.Conclusions In our cohort, perforation was approximately twice as frequent in MeVO than in LVO thrombectomy. Considering the rather benign natural course of MeVO stroke, physicians should be avoiding perforation during MeVO thrombectomy by all means. Efforts to optimize the procedure may focus on navigation beyond the occlusion site and retraction of stent-retriever/aspiration catheter.Disclosure of Interest Nothing to disclose