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Int J Stroke. 2018 Oct 22:1747493018806199. doi: 10.1177/1747493018806199. [Epub ahead of print]

Systematic evaluation of stroke thrombectomy in clinical practice: The German Stroke Registry Endovascular Treatment.

Author information

1
1 Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
2
2 Department for Diagnostic and Interventional Neuroradiology, University of Munich (LMU), Campus Grosshadern, Germany.
3
3 Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.
4
4 Department of Neurology, Ludwig-Maximilians-University, Munich, Germany.
5
5 Institute of Neuroradiology, Charité Universitary Medicine Berlin, Berlin, Germany.
6
6 Department of Neurology, Charité Universitary Medicine Berlin, Berlin, Germany.
7
7 Radiologische Klinik, Universitätsklinikum Bonn, Bonn, Germany.
8
8 Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Bonn, Germany.
9
9 German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
10
10 Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany.
11
11 Institute of Neuroradiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
12
12 Neurologische Abteilung, Asklepios Klinik Altona, Hamburg, Germany.
13
13 Institut für Radiologie und Neuroradiologie, Asklepios Klinik Altona, Hamburg, Germany.
14
14 Department of Neurology, University Hospital Würzburg, Würzburg, Germany.
15
15 Department of Neurology, Klinikum Main-Spessart, Lohr, Germany.
16
16 Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Würzburg, Würzburg, Germany.
17
17 Department of Neuroradiology, Klinikum rechts der Isar Technical University Munich, Munich, Germany.
18
18 Clinic and Policlinic for Neurology, Hospital of the Technical University Munich, Munich, Germany.
19
19 Department of Neurology, RWTH Aachen University, Aachen, Germany.
20
20 Department of Neuroradiology, RWTH Aachen University, Aachen, Germany.
21
21 Department of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.
22
22 Department of Neurology, University Medical Center Göttigen, Göttingen, Germany.
23
23 Department of Neurology, Klinikum Altenburger Land, Altenburg, Germany.
24
24 Department of Neuroradiology, Klinikum Altenburger Land, Altenburg, Germany.
25
25 Department of Neurology, Klinikum Köln Merheim, University of Cologne, Köln, Germany.
26
26 Department of Neuroradiology, Städtische Kliniken Köln, Köln, Germany.
27
27 Department of Neurology, Klinikum Osnabrück, Osnabrück, Germany.
28
28 Department of Radiology, Klinikum Osnabrück, Osnabrück, Germany.
29
29 Department of Neurology, Städtisches Klinikum Lüneburg, Lüneburg, Germany.
30
30 Department of Neurology, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
31
31 Department of Neurology, Klinikum Hanau, Hanau, Germany.
32
32 Department of Neurology, Klinikum Bremen Mitte, Bremen, Germany.
33
33 Clinic for Diagnostic and Interventional Neuroradiology, Hospitals Bremen-Mitte, Bremen, Germany.
34
34 Department of Neurology, Bezirkskrankenhaus Günzburg, Günzburg, Germany.
35
35 Sektion Neuroradiologie Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikums Ulm Standort BKH-Günzburg, Günzburg, Germany.
36
36 Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
37
37 Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.

Abstract

BACKGROUND:

Endovascular treatment has become standard of care for the treatment of acute ischemic stroke with large vessel occlusion. However, patients treated in clinical practice differ from the selected populations randomized in clinical trials.

AIMS:

The German Stroke Registry Endovascular Treatment (GSR-ET) aims at a systematic evaluation of outcome, safety, and process parameters of endovascular stroke treatment in standard of care in Germany.

METHODS:

The GSR-ET is an academic, independent, prospective, multicenter, observational registry study. Participating stroke centers from all over of Germany consecutively enroll patients transferred to the angiography suite with an intention to be treated with endovascular stroke treatment. Patients receive regular care. Data are collected as part of clinical routine. Baseline clinical and procedural information and clinical follow-up information after 90 days are recorded. Here, we present an analysis of baseline data of the first 1662 patients included in the GSR-ET.

RESULTS:

The registry was established in June 2015. By 31 December 2017, 1662 patients were enrolled in 23 active sites. Mean age was 72 ± 13 years, 50% were female, and median National Institutes of Health Stroke Scale on admission was 15 (IQR 10-19), 88% had anterior circulation occlusion. Median ASPECT score was 8 (IQR 7-10) prior to intervention. Fifty-nine percent of patients received intravenous thrombolysis prior to thrombectomy. Mean "onset-to-groin" time was 224 ± 176 min.

CONCLUSIONS:

Baseline characteristics of stroke patients undergoing thrombectomy in clinical practice differ from those in the randomized trials. The GSR-ET will provide valuable insights into practices of endovascular treatment in routine care of acute ischemic stroke. (GSR-ET ClinicalTrials.gov Identifier: NCT03356392.).

KEYWORDS:

Stroke; acute stroke treatment; endovascular treatment; intravenous thrombolysis; mechanical thrombectomy; thrombectomy

PMID:
30346260
DOI:
10.1177/1747493018806199

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