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Rates and Impact of Serious Adverse Events after Endovascular Thrombectomy among Large Vessel Occlusion Stroke

Bo Lei1, Shuang Yang2,3, Ling Tian4

  • 1Department of Cerebrovascular Disease, Leshan People's Hospital, Leshan, China.

Neuroepidemiology
|August 12, 2024
PubMed

Insights

Serious adverse events (SAEs) are common after endovascular thrombectomy (EVT) for stroke, impacting functional independence. Advanced age, higher NIHSS scores, and failed recanalization increase SAE risk, necessitating clinical awareness.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Critical Care Medicine

Background:

  • Serious adverse events (SAEs) are frequent complications in large vessel occlusion stroke treatment.
  • The impact of SAEs on patients undergoing endovascular thrombectomy (EVT) requires further investigation.

Purpose of the Study:

  • To determine the incidence and clinical significance of SAEs in patients after EVT.
  • To identify predictors of SAEs and their association with patient outcomes.

Main Methods:

  • A post hoc analysis of pooled data from the DEVT and RESCUE BT trials.
  • SAEs included symptomatic intracranial hemorrhage, brain herniation, respiratory or circulatory failure, pneumonia, DVT, and systemic bleeding.
  • Functional independence (mRS 0-2 at 90 days) was the primary endpoint; logistic regression analyzed predictors and outcomes.

Main Results:

  • Of 1,182 patients, 63% experienced 1,404 SAEs, with 4.65% in-hospital mortality.
  • Pneumonia (52.5%), systemic bleeding (14.7%), and respiratory failure (14.6%) were most common.
  • Predictors of SAEs included advanced age, higher NIHSS, M2 vs. ICA occlusion, longer procedure time, and failed recanalization. SAEs were associated with lower functional independence (aOR 0.46).

Conclusions:

  • SAEs are prevalent (>60%) after EVT for stroke and linked to functional dependence.
  • Key predictors for SAEs are advanced age, high NIHSS, prolonged procedure duration, and unsuccessful recanalization.
  • Understanding SAE prevalence and predictors aids clinicians in assessing post-EVT risks.
Abstract

Keywords:
ComplicationsEndovascular thrombectomyOutcomeSerious adverse eventsStroke

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