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Treatment practice of vasospasm during endovascular thrombectomy: an international survey

Stroke & Vascular Neurology 2024年第5期9卷 490-496页

作者： Jessica Jesser Thanh Nguyen Adam A Dmytriw Hiroshi Yamagami Zhongrong Miao louisa johanna sommer Andrea Stockero Johannes Alex Rolf Pfaff johanna Ospel Mayank Goyal Aman B Patel Vitor Mendes Pereira Uta Hanning Lukas Meyer Wim H van Zwam Martin Bendszus Martin Wiesmann Markus Möhlenbruch Charlotte Sabine Weyland Neuroradiology University Hospital HeidelbergHeidelbergGermany Neurology Boston University School of MedicineBostonMassachusettsUSA St.Michael's Hospital Departments of Medical Imaging and NeurosurgeryNeurovascular CenterUniversity of TorontoTorontoOntarioCanada Neuroendovascular Program Harvard Medical SchoolMassachusetts General HospitalBostonMassachusettsUSA Stroke Neurology National Hospital Organization Osaka National HospitalOsakaJapan Department of Interventional Neuroradiology Beijing Tiantan HospitalBeijingChina Neuroradiology University Hospital AachenAachenGermany University Insitute for Neuroradiology at PMU Uniklinikum Salzburg—Christian-Doppler-KlinikSalzburgAustria Departments of Diagnostic Imaging and Clinical Neurosciences University of CalgaryCalgaryAlbertaCanada Neuroendovascular Program Massachusetts General HospitalBostonMassachusettsUSA Department of Neurosurgery Unity Health TorontoTorontoOntarioCanada Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention HamburgGermany Diagnostic and Interventional Neuroradiology Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und InterventionHamburgGermany Radiology Maastricht University Medical CenterMaastrichtThe Netherlands

Background and aim The clinical importance and management of vasospasm as a complication during endovascular stroke treatment(EVT)has not been well *** sought to investigate current expert opinions in neurointervention and therapeutic strategies of iatrogenic vasospasm during *** We conducted an anonymous international online survey(4 April 2023 to 15 May 2023)addressing treatment standards of neurointerventionalists(NIs)practising *** illustrative cases of patients with vasospasm during EVT were *** study groups were compared according to the NI’s opinion regarding the potential influence of vasospasm on patient outcome after EVT using descriptive *** In total,534 NI from 56 countries responded,of whom 51.5%had performed>200 *** was considered a complication potentially influencing the patient’s outcome by 52.6%(group 1)whereas 47.4%did not(group 2).Physicians in group 1 more often added vasodilators to their catheter flushes during EVT routinely(43.7%vs 33.9%,p=0.033)and more often treated severe large-vessel vasospasm with vasodilators(75.3%vs 55.9%;p<0.001),as well as extracranial vasospasm(61.4%vs 36.5%,p<0.001)and intracranial medium-vessel vasospasm(27.1%vs 11.2%,p<0.001),compared with group *** case of a large-vessel vasospasm and residual and amenable medium-vessel occlusion during EVT,the study groups showed different treatment *** 2 continued the EVT immediately more often,without initiating therapy to treat the vasospasm first(9.6%vs 21.1%,p<0.001).Conclusion There is disagreement among NIs about the clinical relevance of vasospasm during EVT and its *** was a higher likelihood of use of preventive and active vasodilator treatment in the group that perceived vasospasm as a relevant complication as well as differing interventional strategies for continuing an EVT in the presence of a large-vessel vasospasm.

关键词： survey continued routine

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