Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment

Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Alzayiani, Mohamed [verfasserIn] Schmidt, Tobias [verfasserIn] Veldeman, Michael [verfasserIn] Riabikin, Alexander [verfasserIn] Brockmann, Marc A. [verfasserIn] Schiefer, Johannes [verfasserIn] Clusmann, Hans [verfasserIn] Schubert, Gerrit A. [verfasserIn] Albanna, Walid [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile

Übergeordnetes Werk:	Enthalten in: Journal of the neurological sciences - Amsterdam [u.a.] : Elsevier Science, 1964, 420
Übergeordnetes Werk:	volume:420

DOI / URN:	10.1016/j.jns.2020.117275

Katalog-ID:	ELV00544036X

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024	7		\|a 10.1016/j.jns.2020.117275 \|2 doi
035			\|a (DE-627)ELV00544036X
035			\|a (ELSEVIER)S0022-510X(20)30611-0
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084			\|a 44.90 \|2 bkl
100	1		\|a Alzayiani, Mohamed \|e verfasserin \|4 aut
245	1	0	\|a Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
264		1	\|c 2020
336			\|a nicht spezifiziert \|b zzz \|2 rdacontent
337			\|a Computermedien \|b c \|2 rdamedia
338			\|a Online-Ressource \|b cr \|2 rdacarrier
520			\|a Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden.
650		4	\|a Decompressive hemicraniectomy
650		4	\|a Stroke
650		4	\|a Malignant middle cerebral artery infarction (MMI)
650		4	\|a Thrombolysis
650		4	\|a Thrombectomy
650		4	\|a Risk profile
700	1		\|a Schmidt, Tobias \|e verfasserin \|4 aut
700	1		\|a Veldeman, Michael \|e verfasserin \|4 aut
700	1		\|a Riabikin, Alexander \|e verfasserin \|4 aut
700	1		\|a Brockmann, Marc A. \|e verfasserin \|4 aut
700	1		\|a Schiefer, Johannes \|e verfasserin \|4 aut
700	1		\|a Clusmann, Hans \|e verfasserin \|4 aut
700	1		\|a Schubert, Gerrit A. \|e verfasserin \|4 aut
700	1		\|a Albanna, Walid \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|t Journal of the neurological sciences \|d Amsterdam [u.a.] : Elsevier Science, 1964 \|g 420 \|h Online-Ressource \|w (DE-627)306661152 \|w (DE-600)1500645-1 \|w (DE-576)081986742 \|x 1878-5883 \|7 nnns
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912			\|a GBV_ILN_2064
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912			\|a GBV_ILN_2068
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912			\|a GBV_ILN_2112
912			\|a GBV_ILN_2113
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912			\|a GBV_ILN_2129
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912			\|a GBV_ILN_2147
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912			\|a GBV_ILN_2153
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912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4242
912			\|a GBV_ILN_4251
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4313
912			\|a GBV_ILN_4323
912			\|a GBV_ILN_4324
912			\|a GBV_ILN_4325
912			\|a GBV_ILN_4326
912			\|a GBV_ILN_4333
912			\|a GBV_ILN_4334
912			\|a GBV_ILN_4335
912			\|a GBV_ILN_4338
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936	b	k	\|a 44.90 \|j Neurologie
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publishDate	2020
allfields	10.1016/j.jns.2020.117275 doi (DE-627)ELV00544036X (ELSEVIER)S0022-510X(20)30611-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Alzayiani, Mohamed verfasserin aut Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden. Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile Schmidt, Tobias verfasserin aut Veldeman, Michael verfasserin aut Riabikin, Alexander verfasserin aut Brockmann, Marc A. verfasserin aut Schiefer, Johannes verfasserin aut Clusmann, Hans verfasserin aut Schubert, Gerrit A. verfasserin aut Albanna, Walid verfasserin aut Enthalten in Journal of the neurological sciences Amsterdam [u.a.] : Elsevier Science, 1964 420 Online-Ressource (DE-627)306661152 (DE-600)1500645-1 (DE-576)081986742 1878-5883 nnns volume:420 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 420
spelling	10.1016/j.jns.2020.117275 doi (DE-627)ELV00544036X (ELSEVIER)S0022-510X(20)30611-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Alzayiani, Mohamed verfasserin aut Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden. Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile Schmidt, Tobias verfasserin aut Veldeman, Michael verfasserin aut Riabikin, Alexander verfasserin aut Brockmann, Marc A. verfasserin aut Schiefer, Johannes verfasserin aut Clusmann, Hans verfasserin aut Schubert, Gerrit A. verfasserin aut Albanna, Walid verfasserin aut Enthalten in Journal of the neurological sciences Amsterdam [u.a.] : Elsevier Science, 1964 420 Online-Ressource (DE-627)306661152 (DE-600)1500645-1 (DE-576)081986742 1878-5883 nnns volume:420 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 420
allfields_unstemmed	10.1016/j.jns.2020.117275 doi (DE-627)ELV00544036X (ELSEVIER)S0022-510X(20)30611-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Alzayiani, Mohamed verfasserin aut Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden. Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile Schmidt, Tobias verfasserin aut Veldeman, Michael verfasserin aut Riabikin, Alexander verfasserin aut Brockmann, Marc A. verfasserin aut Schiefer, Johannes verfasserin aut Clusmann, Hans verfasserin aut Schubert, Gerrit A. verfasserin aut Albanna, Walid verfasserin aut Enthalten in Journal of the neurological sciences Amsterdam [u.a.] : Elsevier Science, 1964 420 Online-Ressource (DE-627)306661152 (DE-600)1500645-1 (DE-576)081986742 1878-5883 nnns volume:420 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 420
allfieldsGer	10.1016/j.jns.2020.117275 doi (DE-627)ELV00544036X (ELSEVIER)S0022-510X(20)30611-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Alzayiani, Mohamed verfasserin aut Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden. Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile Schmidt, Tobias verfasserin aut Veldeman, Michael verfasserin aut Riabikin, Alexander verfasserin aut Brockmann, Marc A. verfasserin aut Schiefer, Johannes verfasserin aut Clusmann, Hans verfasserin aut Schubert, Gerrit A. verfasserin aut Albanna, Walid verfasserin aut Enthalten in Journal of the neurological sciences Amsterdam [u.a.] : Elsevier Science, 1964 420 Online-Ressource (DE-627)306661152 (DE-600)1500645-1 (DE-576)081986742 1878-5883 nnns volume:420 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 420
allfieldsSound	10.1016/j.jns.2020.117275 doi (DE-627)ELV00544036X (ELSEVIER)S0022-510X(20)30611-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Alzayiani, Mohamed verfasserin aut Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden. Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile Schmidt, Tobias verfasserin aut Veldeman, Michael verfasserin aut Riabikin, Alexander verfasserin aut Brockmann, Marc A. verfasserin aut Schiefer, Johannes verfasserin aut Clusmann, Hans verfasserin aut Schubert, Gerrit A. verfasserin aut Albanna, Walid verfasserin aut Enthalten in Journal of the neurological sciences Amsterdam [u.a.] : Elsevier Science, 1964 420 Online-Ressource (DE-627)306661152 (DE-600)1500645-1 (DE-576)081986742 1878-5883 nnns volume:420 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 420
language	English
source	Enthalten in Journal of the neurological sciences 420 volume:420
sourceStr	Enthalten in Journal of the neurological sciences 420 volume:420
format_phy_str_mv	Article
bklname	Neurologie
institution	findex.gbv.de
topic_facet	Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile
dewey-raw	610
isfreeaccess_bool	false
container_title	Journal of the neurological sciences
authorswithroles_txt_mv	Alzayiani, Mohamed @@aut@@ Schmidt, Tobias @@aut@@ Veldeman, Michael @@aut@@ Riabikin, Alexander @@aut@@ Brockmann, Marc A. @@aut@@ Schiefer, Johannes @@aut@@ Clusmann, Hans @@aut@@ Schubert, Gerrit A. @@aut@@ Albanna, Walid @@aut@@
publishDateDaySort_date	2020-01-01T00:00:00Z
hierarchy_top_id	306661152
dewey-sort	3610
id	ELV00544036X
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">ELV00544036X</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230524123013.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230504s2020 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.jns.2020.117275</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV00544036X</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S0022-510X(20)30611-0</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">DE-600</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.90</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Alzayiani, Mohamed</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Decompressive hemicraniectomy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Stroke</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Malignant middle cerebral artery infarction (MMI)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Thrombolysis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield 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author	Alzayiani, Mohamed
spellingShingle	Alzayiani, Mohamed ddc 610 bkl 44.90 misc Decompressive hemicraniectomy misc Stroke misc Malignant middle cerebral artery infarction (MMI) misc Thrombolysis misc Thrombectomy misc Risk profile Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
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topic_title	610 DE-600 44.90 bkl Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment Decompressive hemicraniectomy Stroke Malignant middle cerebral artery infarction (MMI) Thrombolysis Thrombectomy Risk profile
topic	ddc 610 bkl 44.90 misc Decompressive hemicraniectomy misc Stroke misc Malignant middle cerebral artery infarction (MMI) misc Thrombolysis misc Thrombectomy misc Risk profile
topic_unstemmed	ddc 610 bkl 44.90 misc Decompressive hemicraniectomy misc Stroke misc Malignant middle cerebral artery infarction (MMI) misc Thrombolysis misc Thrombectomy misc Risk profile
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title	Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
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title_full	Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
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author_browse	Alzayiani, Mohamed Schmidt, Tobias Veldeman, Michael Riabikin, Alexander Brockmann, Marc A. Schiefer, Johannes Clusmann, Hans Schubert, Gerrit A. Albanna, Walid
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title_sort	risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
title_auth	Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
abstract	Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden.
abstractGer	Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden.
abstract_unstemmed	Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden.
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title_short	Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment
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up_date	2024-07-06T17:58:49.436Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">ELV00544036X</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230524123013.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230504s2020 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.jns.2020.117275</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV00544036X</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S0022-510X(20)30611-0</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">DE-600</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.90</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Alzayiani, Mohamed</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objective: Revascularization by pharmacological and/or endovascular treatment is an effective therapy for acute ischemic stroke caused by artery occlusion. In the context of malignant middle cerebral artery infarction (MMI), decompressive hemicraniectomy (DHC) can be life-saving. However, its effectiveness and safety after revascularization have not been thoroughly assessed. This retrospective study aimed to determine the risk profile of pre-surgical revascularization treatment (RT) for subsequent DHC.Methods: A total of 152 consecutive patients treated by DHC after MMI were identified between 2012 and 2015. After elimination of cases with previous stroke and cases pre-treated with antiplatelets or anticoagulants (increased postoperative bleeding), twenty-four out of fifty patients (n = 24/50, 48%) received pre-surgical revascularization treatment by intravenous thrombolysis (TL), mechanical thrombectomy (MT) or a combination of both. Demographic data was compared alongside perioperative, postoperative complications (intra−/extracerebral hemorrhage, revision surgery due to hemorrhage or infection, and overall mortality) and economic parameters.Results: Comparing patients with and without prior RT, there was no statistically significant difference in duration of surgery (RT: 83 [57–116] min vs. no-RT: 96 [69–119] min, p = 0.308), intraoperative blood loss (RT: 300 [225–375] ml vs. no-RT: 300 [250–400] ml, p = 0.763), intraoperative transfusion requirement (RT: 12.5% vs. no-RT: 26.9%, p = 0.294), or need for volume substitution (RT: 1300 [1200–1400] ml vs. no-RT: 1200 [1100–1400] ml, p = 0.359). The rate of postoperative complications was also comparable in both groups, including intra−/extracerebral hemorrhage, revision due to hemorrhage or infections, and mortality (p = 0.814, p = 0.520, p = 0.697, and p = 0.769). Health economic parameters were not affected (ventilation time: RT: 309 [12–527] hrs. vs. no-RT: 444 [171–605] hrs., p = 0.120, length of stay: RT: 23 [13−32] days vs. no-RT: 28 [19–41], p = 0.156, and stay costs: RT: 27768 [13044–60,248] € vs. no-RT: 35422 [21225–49,585] €, p = 0.312).Conclusion: DHC for patients with MMI who previously received revascularization therapy appears to be safe and not associated with a higher complication rate or increased health economic burden.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Decompressive hemicraniectomy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Stroke</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Malignant middle cerebral artery infarction (MMI)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Thrombolysis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield 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Risk profile of decompressive hemicraniectomy for malignant stroke after revascularization treatment

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