Mechanical thrombectomy in acute stroke patients during covid-19; comparison of pre-pandemic and pandemic data


Çapar A. E., Sercan Bıtrak G., Baş D. F., Sarıoğlu O., Arslan K. E., Atasoy G., ...Daha Fazla

2023 Annual Meeting of TSIR and EVIS International Joint Meeting,, Antalya, Türkiye, 10 - 14 Mart 2023, ss.6-7

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.6-7
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Aim: To evaluate the reflection of the pandemic, on the mechanical thrombectomy (MT) management of acute stroke

Method: We retrospectively evaluated 100 acute ischemic stroke patients between March 1, 2019- Februray 29, 2020, and between March 1, 2020 - March 1, 2021, who underwent MT at our institute. Patients were divided into two groups as those who underwent MT before the Covid 19 pandemic (group 1) and those who underwent MT during the period of Covid 19 pandemic (group 2). All the diagnosis of stroke patients was confirmed by MRI and CT. Demographics, clinical and laboratory data were recorded. National Institutes of Health Stroke Scale (NIHSS) score on pre-hospitalization and at discharge, ASPECT score, occluded vessel location, use of preprocedural lytic medication, modified Rankin scores (mRS), procedure times (onset to groin puncture, door to needle, groin puncture to recanalization), device pass counts until successful recanalization or last angiogram if recanalization failed, Thrombolysis in Cerebral İnfarction (TICI) scales, early neurological improvements, post-procedure hemorrhage, decompression surgery, type of anesthesia during procedure and periprocedural complications were analyzed between groups. TOAST classification was used for stroke etiology.

MT findings; symptom onset to groin puncture and recanalization times, first pass effect defined with single device pass with TICI 2b/3 recanalization and final recanalization, admission and NIHHS scores and 3rd month mRS scores, postprocedural hemorrage rates were compared between groups.

The SPSS version 26.0 was used for statistical analysis. The distribution of variables was assessed by the

Kolmogorov- Smirnov test. Categorical variable was evaluated using Chi-square test or Fisher’s exact test. Mann- Whitney U test or independent t-test was used for comparing continuous variables.

Result: A total of 100 patients, 50 before and 50 after the pandemic, were included in the study. No statistically significant difference was observed between the groups in terms of demographic data and risk factors. The time from symptom onset to groin puncture was
significantly longer during the pandemic period than before (p=0.001). No significant difference was observed in the time from groin puncture to recanalization (p=0.251), recanalization rates (p=0.806) and the number of passes (p=0.889). There was no difference between the pre-pandemic and post-pandemic groups in terms of the frequency of intracranial hemorrhage (p=0.501), complication (p=0.153) and decompression (p=0.538) after MT. The mRS scores at 3 months were similar (p=0.316).

Conclusion: As a result, the time from symptom to procedure is prolonged in acute ischemic stroke patients who underwent MT in our center during the pandemic period.İn the respect of procedural findings and outcomes of MT before and during pandemic, there had been no significant change at our center.