Wouter H Hinsenveld, Josje Brouwer, Sanne J den Hartog, Agnetha Bruggeman, Manon Kappelhof, Ivo Gh Jansen, Maxim Jhl Mulder, Kars Cj Compagne, Robert-Jan B Goldhoorn, Hester Lingsma, Geert Lycklama À Nijeholt, Rob Ar Gons, Lonneke Fs Yo, Maarten Uyttenboogaart, Reinoud Bokkers, Bart H van der Worp, Rob H Lo, Wouter Schonewille, Paul Brouwers, Tomas Bulut, Jasper Mm Martens, Jeannette Hofmeijer, Boudewijn Aam van Hasselt, Heleen den Hertog, Sebastiaan F de Bruijn, Lukas C van Dijk, Marianne A van Walderveen, Marieke Wermer, Hieronymus Boogaarts, Ewoud J van Dijk, Julia H van Tuijl, Issam Boukrab, Tobien Ahcml Schreuder, Roeland Heijboer, Anouk D Rozeman, Ludo Fm Beenen, Alida A Postma, Albert J Yoo, Stefan D Roosendaal, Jeannette Bakker, Adriaan Cgm van Es, Sjoerd Jenniskens, Ido Remy van den Wijngaard, Menno Krietemeijer, René van den Berg, Joseph Cj Bot, Sebastiaan Hammer, Marieke Sprengers, Frederick Jan Anton Meijer, Miou S Koopman, Elyas Ghariq, Auke Pa Appelman, Anouk van der Hoorn, Marc P van Proosdij, Bas Fw van der Kallen, Olvert A Berkhemer, Jeroen E Markenstein, Eef J Hendriks, Jo Pp Peluso, Christiaan van der Leij, Lucas Smagge, Saman Vinke, Sjoerd Pegge, Wouter Dinkelaar, Jan Albert Vos, Jelis Boiten, Inger de Ridder, Jonathan Coutinho, Bart J Emmer, Pieter Jan van Doormaal, Bob Roozenbeek, Yvo Bwem Roos, Charles Blm Majoie, Diederik Wj Dippel, Aad van der Lugt, Wim van Zwam, Robert van Oostenbrugge
{"title":"急性缺血性卒中患者特征、介入技术和血管内治疗结果的国家趋势：MR CLEAN Registry（2014-2018）的最终结果。","authors":"Wouter H Hinsenveld, Josje Brouwer, Sanne J den Hartog, Agnetha Bruggeman, Manon Kappelhof, Ivo Gh Jansen, Maxim Jhl Mulder, Kars Cj Compagne, Robert-Jan B Goldhoorn, Hester Lingsma, Geert Lycklama À Nijeholt, Rob Ar Gons, Lonneke Fs Yo, Maarten Uyttenboogaart, Reinoud Bokkers, Bart H van der Worp, Rob H Lo, Wouter Schonewille, Paul Brouwers, Tomas Bulut, Jasper Mm Martens, Jeannette Hofmeijer, Boudewijn Aam van Hasselt, Heleen den Hertog, Sebastiaan F de Bruijn, Lukas C van Dijk, Marianne A van Walderveen, Marieke Wermer, Hieronymus Boogaarts, Ewoud J van Dijk, Julia H van Tuijl, Issam Boukrab, Tobien Ahcml Schreuder, Roeland Heijboer, Anouk D Rozeman, Ludo Fm Beenen, Alida A Postma, Albert J Yoo, Stefan D Roosendaal, Jeannette Bakker, Adriaan Cgm van Es, Sjoerd Jenniskens, Ido Remy van den Wijngaard, Menno Krietemeijer, René van den Berg, Joseph Cj Bot, Sebastiaan Hammer, Marieke Sprengers, Frederick Jan Anton Meijer, Miou S Koopman, Elyas Ghariq, Auke Pa Appelman, Anouk van der Hoorn, Marc P van Proosdij, Bas Fw van der Kallen, Olvert A Berkhemer, Jeroen E Markenstein, Eef J Hendriks, Jo Pp Peluso, Christiaan van der Leij, Lucas Smagge, Saman Vinke, Sjoerd Pegge, Wouter Dinkelaar, Jan Albert Vos, Jelis Boiten, Inger de Ridder, Jonathan Coutinho, Bart J Emmer, Pieter Jan van Doormaal, Bob Roozenbeek, Yvo Bwem Roos, Charles Blm Majoie, Diederik Wj Dippel, Aad van der Lugt, Wim van Zwam, Robert van Oostenbrugge","doi":"10.1177/23969873251334271","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular thrombectomy (EVT) procedures and workflow have evolved over the years. We examined trends in patient characteristics, EVT techniques and outcomes over 5 years in the Netherlands.</p><p><strong>Patients and methods: </strong>Data from the MR CLEAN Registry (2014-2018) were analysed, including patients treated with EVT for anterior circulation acute ischaemic stroke (AIS). Patients were grouped by year of inclusion except for the linear regression analysis where the inclusion date was used. Baseline predicted probability of poor outcome (modified Rankin Scale (mRS) score 3-6) was calculated using a validated prediction model. Primary outcome was mRS score at 90 days. Secondary outcomes included workflow times, EVT techniques, successful reperfusion (eTICI ⩾ 2B) and symptomatic intracranial haemorrhage (sICH). Time trends were analysed using multivariable regression models (adjusted common odds ratios (acOR) per year).</p><p><strong>Results: </strong>5193 patients were included. Median age increased (from 66 in 2014 to 74 years in 2018 [<i>p</i> < 0.001]). Proportion of patients with pre-stroke dependence (mRS ⩾ 3) increased from 2014 through 2018 (9% to 16%, <i>p</i> < 0.001). Baseline predicted probability of poor outcome did not change (60% vs 66%, <i>p</i> = 0.06). Over time, functional outcomes improved (acOR 1.14 per year, 95%CI: 1.09-1.20); mortality decreased (aOR 0.88 per year, 95%CI: 0.83-0.94). EVT under local anaesthesia increased (from 46% in 2014 to 70% in 2018; aOR 1.15, 95%CI: 1.10-1.22), as did use of direct aspiration (13%-36%; aOR 1.43, 95%CI: 1.35-1.53). Successful reperfusion became more frequent (aOR 1.32 per year, 95%CI: 1.25-1.40), despite needing more attempts (1 in 2014 vs 2 in 2018, aOR 0.93 per year, 95%CI: 0.89-0.98). Incidence of sICH remained unchanged (5% vs 5%, aOR 0.99 per year, 95%CI: 0.89-1.09). Time from emergency room to groin puncture reduced by 7 min per year (95%CI: 5-8).</p><p><strong>Discussion and conclusion: </strong>Enhanced workflow and increased EVT experience may have led to shorter time to treatment and more frequent successful reperfusion, with better functional outcomes over 5 years, despite treating older, more dependent patients.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"23969873251334271"},"PeriodicalIF":5.8000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049364/pdf/","citationCount":"0","resultStr":"{\"title\":\"National trends in patient characteristics, interventional techniques and outcomes of endovascular treatment for acute ischaemic stroke: Final results of the MR CLEAN Registry (2014-2018).\",\"authors\":\"Wouter H Hinsenveld, Josje Brouwer, Sanne J den Hartog, Agnetha Bruggeman, Manon Kappelhof, Ivo Gh Jansen, Maxim Jhl Mulder, Kars Cj Compagne, Robert-Jan B Goldhoorn, Hester Lingsma, Geert Lycklama À Nijeholt, Rob Ar Gons, Lonneke Fs Yo, Maarten Uyttenboogaart, Reinoud Bokkers, Bart H van der Worp, Rob H Lo, Wouter Schonewille, Paul Brouwers, Tomas Bulut, Jasper Mm Martens, Jeannette Hofmeijer, Boudewijn Aam van Hasselt, Heleen den Hertog, Sebastiaan F de Bruijn, Lukas C van Dijk, Marianne A van Walderveen, Marieke Wermer, Hieronymus Boogaarts, Ewoud J van Dijk, Julia H van Tuijl, Issam Boukrab, Tobien Ahcml Schreuder, Roeland Heijboer, Anouk D Rozeman, Ludo Fm Beenen, Alida A Postma, Albert J Yoo, Stefan D Roosendaal, Jeannette Bakker, Adriaan Cgm van Es, Sjoerd Jenniskens, Ido Remy van den Wijngaard, Menno Krietemeijer, René van den Berg, Joseph Cj Bot, Sebastiaan Hammer, Marieke Sprengers, Frederick Jan Anton Meijer, Miou S Koopman, Elyas Ghariq, Auke Pa Appelman, Anouk van der Hoorn, Marc P van Proosdij, Bas Fw van der Kallen, Olvert A Berkhemer, Jeroen E Markenstein, Eef J Hendriks, Jo Pp Peluso, Christiaan van der Leij, Lucas Smagge, Saman Vinke, Sjoerd Pegge, Wouter Dinkelaar, Jan Albert Vos, Jelis Boiten, Inger de Ridder, Jonathan Coutinho, Bart J Emmer, Pieter Jan van Doormaal, Bob Roozenbeek, Yvo Bwem Roos, Charles Blm Majoie, Diederik Wj Dippel, Aad van der Lugt, Wim van Zwam, Robert van Oostenbrugge\",\"doi\":\"10.1177/23969873251334271\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Endovascular thrombectomy (EVT) procedures and workflow have evolved over the years. We examined trends in patient characteristics, EVT techniques and outcomes over 5 years in the Netherlands.</p><p><strong>Patients and methods: </strong>Data from the MR CLEAN Registry (2014-2018) were analysed, including patients treated with EVT for anterior circulation acute ischaemic stroke (AIS). Patients were grouped by year of inclusion except for the linear regression analysis where the inclusion date was used. Baseline predicted probability of poor outcome (modified Rankin Scale (mRS) score 3-6) was calculated using a validated prediction model. Primary outcome was mRS score at 90 days. Secondary outcomes included workflow times, EVT techniques, successful reperfusion (eTICI ⩾ 2B) and symptomatic intracranial haemorrhage (sICH). Time trends were analysed using multivariable regression models (adjusted common odds ratios (acOR) per year).</p><p><strong>Results: </strong>5193 patients were included. Median age increased (from 66 in 2014 to 74 years in 2018 [<i>p</i> < 0.001]). Proportion of patients with pre-stroke dependence (mRS ⩾ 3) increased from 2014 through 2018 (9% to 16%, <i>p</i> < 0.001). Baseline predicted probability of poor outcome did not change (60% vs 66%, <i>p</i> = 0.06). Over time, functional outcomes improved (acOR 1.14 per year, 95%CI: 1.09-1.20); mortality decreased (aOR 0.88 per year, 95%CI: 0.83-0.94). EVT under local anaesthesia increased (from 46% in 2014 to 70% in 2018; aOR 1.15, 95%CI: 1.10-1.22), as did use of direct aspiration (13%-36%; aOR 1.43, 95%CI: 1.35-1.53). Successful reperfusion became more frequent (aOR 1.32 per year, 95%CI: 1.25-1.40), despite needing more attempts (1 in 2014 vs 2 in 2018, aOR 0.93 per year, 95%CI: 0.89-0.98). Incidence of sICH remained unchanged (5% vs 5%, aOR 0.99 per year, 95%CI: 0.89-1.09). Time from emergency room to groin puncture reduced by 7 min per year (95%CI: 5-8).</p><p><strong>Discussion and conclusion: </strong>Enhanced workflow and increased EVT experience may have led to shorter time to treatment and more frequent successful reperfusion, with better functional outcomes over 5 years, despite treating older, more dependent patients.</p>\",\"PeriodicalId\":46821,\"journal\":{\"name\":\"European Stroke Journal\",\"volume\":\" \",\"pages\":\"23969873251334271\"},\"PeriodicalIF\":5.8000,\"publicationDate\":\"2025-05-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049364/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Stroke Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/23969873251334271\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Stroke Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/23969873251334271","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
National trends in patient characteristics, interventional techniques and outcomes of endovascular treatment for acute ischaemic stroke: Final results of the MR CLEAN Registry (2014-2018).
Introduction: Endovascular thrombectomy (EVT) procedures and workflow have evolved over the years. We examined trends in patient characteristics, EVT techniques and outcomes over 5 years in the Netherlands.
Patients and methods: Data from the MR CLEAN Registry (2014-2018) were analysed, including patients treated with EVT for anterior circulation acute ischaemic stroke (AIS). Patients were grouped by year of inclusion except for the linear regression analysis where the inclusion date was used. Baseline predicted probability of poor outcome (modified Rankin Scale (mRS) score 3-6) was calculated using a validated prediction model. Primary outcome was mRS score at 90 days. Secondary outcomes included workflow times, EVT techniques, successful reperfusion (eTICI ⩾ 2B) and symptomatic intracranial haemorrhage (sICH). Time trends were analysed using multivariable regression models (adjusted common odds ratios (acOR) per year).
Results: 5193 patients were included. Median age increased (from 66 in 2014 to 74 years in 2018 [p < 0.001]). Proportion of patients with pre-stroke dependence (mRS ⩾ 3) increased from 2014 through 2018 (9% to 16%, p < 0.001). Baseline predicted probability of poor outcome did not change (60% vs 66%, p = 0.06). Over time, functional outcomes improved (acOR 1.14 per year, 95%CI: 1.09-1.20); mortality decreased (aOR 0.88 per year, 95%CI: 0.83-0.94). EVT under local anaesthesia increased (from 46% in 2014 to 70% in 2018; aOR 1.15, 95%CI: 1.10-1.22), as did use of direct aspiration (13%-36%; aOR 1.43, 95%CI: 1.35-1.53). Successful reperfusion became more frequent (aOR 1.32 per year, 95%CI: 1.25-1.40), despite needing more attempts (1 in 2014 vs 2 in 2018, aOR 0.93 per year, 95%CI: 0.89-0.98). Incidence of sICH remained unchanged (5% vs 5%, aOR 0.99 per year, 95%CI: 0.89-1.09). Time from emergency room to groin puncture reduced by 7 min per year (95%CI: 5-8).
Discussion and conclusion: Enhanced workflow and increased EVT experience may have led to shorter time to treatment and more frequent successful reperfusion, with better functional outcomes over 5 years, despite treating older, more dependent patients.
期刊介绍：
Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
