Clinical consequence of vessel perforations during endovascular treatment of acute ischemic stroke.

P Matthijs Van Der Sluijs,Katinka R Van Kranendonk,Nicoline Aaldering,R Su,D Jeurrissen,Yvonne Drabbe,Hester Bongenaar,Marc P Van Proosdij,Maureen Wollaert,Tamara Vermeulen,Jasmijn Lodico,Marieke A Mens,Berber Zweedijk,Jasper M Martens,Robert J Van Oostenbrugge,Eva J H F Voogd,Paul J A M Brouwers,Lukas C Van Dijk,Marjan Elfrink,Rita Sprengers,Lucas A Ramos,Ivo G H Jansen,P F C Groot,Sandra Kleijn,Alida A Postma,Olvert A Berkhemer,Josje Brouwer,Marianne A A Van Walderveen,Paul L M De Kort,René Van Den Berg,Wilma Pellikaan,Karin Kanselaar,Ludo F M Beenen,Tobien H C M L Schreuder,Annick J Eleonora L F Weteringskirkels,Charles B L M Majoie,Sebastiaan F De Bruijn,Maarten Uyttenboogaart,Bas F W Van Der Kallen,Denn Barning,H Zwenneke Flach,Saman Vinke,Manon Kappelhof,Bart J Emmer,Jan S P Van Den Berg,G Menno Krietemeijer,Sanne J Den Hartog,Joost Bot,Heleen M Den Hertog,Erna Bos,Tiny Simons,G Lycklama A Nijeholt,Haryadi Prasetya,Marieke J H Wermer,Praneeta R Konduri,Julia Van Tuijl,Robert-Jan B Goldhoorn,Wim H Van Zwam,Nynke Nicolaij,Jan Albert Vos,Rob H Lo,Ido R Van Den Wijngaard,Adrien E D Groot,Wouter J Schonewille,Tomas Bulut,Sjoert Pegge,Omid Eschgi,René J Dallinga,Daan Anouk Muijresde Jong,Michelle Simons,Vicky Ralph R Chalosgeuskens,Auke P A Appelman,Hanneke Droste,Kars C J Compagne,Natalie E Lecouffe,S A P Cornelissen,Julie Staals,Naziha El Ghannouti,Wouter H Hinsenveld,Karin Bodde,Sjoerd F M Jenniskens,Sharon Romviel,Elyas Ghariq,Jelis Boiten,A Van Der Lugt,Manon L Tolhuisen,Roel J J Heijboer,Eva Ponjee,Esmee Venema,A C G M Van Es,Kilian M Treurniet,Annet Geerlings,H Bart Van Der Worp,Sabine L Collette,Diederik W J Dippel,T Van Walsum,Nerea Arrarte-Terreros,Martin Sterrenberg,Lieve M Schupp,Joke De Meris,Gert Messchendorp,Yvo B W E M Roos,Lonneke S F Yo,Michelle Sandiman,Hieronymus D Boogaarts,Sabrina Verheesen,Jo P Peluso,Puck Fransen,Anouk Van Der Hoorn,Roger R M Harmsma,Gina Van Vemde,Koos Keizer,Marjolein Vossers,Anton Meijer,J De Vries,Boudewijn A A M Van Hasselt,Tim Van Straaten,Ewoud J Van Dijk,P J Van Doormaal,J Hofmeijer,Leo A M Aerden,Stefan D Roosendaal,Albert J Yoo,Marieke E S Sprengers,Maxim J H L Mulder,Hester F Lingsma,Reinoud P H Bokkers,B Roozenbeek,Heitor Alves,Bas Hammer,Saliha Ergezen,Wouter Dinkelaar,Jocova Vervoort,Jonathan M Coutinho,Anna M M J Boershuguet

doi:10.1007/s00234-023-03246-2

P Matthijs Van Der Sluijs, Katinka R Van Kranendonk + Show 133 more

Open Access

https://doi.org/10.1007/s00234-023-03246-2

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Abstract

Endovascular treatment (EVT) of acute ischemic stroke can be complicated by vessel perforation. We studied the incidence and determinants of vessel perforations. In addition, we studied the association of vessel perforations with functional outcome, and the association between location of perforation on digital subtraction angiography (DSA) and functional outcome, using a large EVT registry. We included all patients in the MR CLEAN Registry who underwent EVT. We used DSA to determine whether EVT was complicated by a vessel perforation. We analyzed the association with baseline clinical and interventional parameters using logistic regression models. Functional outcome was measured using the modified Rankin Scale at 90days. The association between vessel perforation and angiographic imaging features and functional outcome was studied using ordinal logistic regression models adjusted for prognostic parameters. These associations were expressed as adjusted common odds ratios (acOR). Vessel perforation occurred in 74 (2.6%) of 2794 patients who underwent EVT. Female sex (aOR 2.0 (95% CI 1.2-3.2)) and distal occlusion locations (aOR 2.2 (95% CI 1.3-3.5)) were associated with increased risk of vessel perforation. Functional outcome was worse in patients with vessel perforation (acOR 0.38 (95% CI 0.23-0.63)) compared to patients without a vessel perforation. No significant association was found between location of perforation and functional outcome. The incidence of vessel perforation during EVT in this cohort was low, but has severe clinical consequences. Female patients and patients treated at distal occlusion locations are at higher risk.

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