title: Eligibility for mechanical thrombectomy in acute ischemic stroke: A phase IV multi-center screening log registry.
abstract: No eligibility screening logs were kept in recent mechanical thrombectomy (MT) RCTs establishing safety and efficacy of endovascular reperfusion therapies for acute ischemic stroke (AIS). We sought to evaluate the potential eligibility for MT among consecutive AIS patients in a prospective international multicenter study. We prospectively evaluated consecutive AIS patients admitted in four tertiary-care stroke centers during a twelve-month period. Potential eligibility for MT was evaluated using inclusion criteria from MR CLEAN & REVASCAT. Our study population consisted of 1464 AIS patients (mean age 67±14years, 56% men, median admission NIHSS-score: 5, IQR: 3-10). A total of 123 (8%, 95% CI: 7%-10%) and 82 (6%, 95% CI: 5%-7%) patients fulfilled the inclusion criteria for MR CLEAN&REVASCAT respectively. No evidence of heterogeneity (p>0.100) was found in the eligibility for MT across the participating centers. Absence of proximal intracranial occlusion (69%) and hospital arrival outside the eligible time window (38% for MR CLEAN & 35% for REVASCAT) were the two most common reasons for ineligibility for MT. Our everyday clinical practice experience suggests that approximately one out of thirteen to seventeen consecutive AIS may be eligible for MT if inclusion criteria for MR CLEAN and REVASCAT are strictly adhered to.
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States; Second Department of Neurology, "Attikon University Hospital", School of Medicine, University of Athens, Athens, Greece; International Clinical Research Center, St. Anne's Hospital, Brno, Czech Republic. Electronic address: tsivgoulisgiorg@yahoo.gr.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsivgoulis
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Nitin
authors.initials: N
authors.lastname: Goyal
authors.affiliation: International Clinical Research Center, St. Anne's Hospital, Brno, Czech Republic; First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Mikulik
authors.affiliation: Division of Neurology, National University Hospital System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Sharma
authors.affiliation: Second Department of Neurology, "Attikon University Hospital", School of Medicine, University of Athens, Athens, Greece.
authors.forename: Aristeidis H
authors.initials: AH
authors.lastname: Katsanos
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Ramin
authors.initials: R
authors.lastname: Zand
authors.affiliation: Division of Neurology, National University Hospital System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Prakash R
authors.initials: PR
authors.lastname: Paliwal
authors.affiliation: Second Department of Neurology, "Attikon University Hospital", School of Medicine, University of Athens, Athens, Greece.
authors.forename: Andromachi
authors.initials: A
authors.lastname: Roussopoulou
authors.affiliation: International Clinical Research Center, St. Anne's Hospital, Brno, Czech Republic; First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Volny
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Abhi
authors.initials: A
authors.lastname: Pandhi
authors.affiliation: Second Department of Neurology, "Attikon University Hospital", School of Medicine, University of Athens, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Zompola
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Lucas
authors.initials: L
authors.lastname: Elijovich
authors.affiliation: Second Department of Neurology, "Attikon University Hospital", School of Medicine, University of Athens, Athens, Greece; Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Safouris
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Jason
authors.initials: J
authors.lastname: Chang
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.
authors.forename: Andrei V
authors.initials: AV
authors.lastname: Alexandrov
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States; Australian Catholic University, Sydney, Australia.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Alexandrov
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000628:therapy*; D004282:Documentation; D004608:Eligibility Determination; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D020521:Stroke / Q000628:therapy*; D062606:Tertiary Care Centers; D061665:Time-to-Treatment
keywords: Acute ischemic stroke; Eligibility; Emergent large vessel occlusion; Mechanical thrombectomy