International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy


Adam A. Dmytriw
Sherief Ghozy
Ahmad Sweid
Michel Piotin
Kimon Bekelis
Nader Sourour
Eytan Raz
Daniel Vela-Duarte
Italo Linfante
Guilherme Dabus
Max Kole, Henry Ford HealthFollow
Mario Martínez-Galdámez
Shahid M. Nimjee
Demetrius K. Lopes
Ameer E. Hassan
Peter Kan
Mohammad Ghorbani
Michael R. Levitt
Simon Escalard
Symeon Missios
Maksim Shapiro
Fréderic Clarençon
Mahmoud Elhorany
Rizwan A. Tahir, Henry Ford HealthFollow
Patrick P. Youssef
Aditya S. Pandey
Robert M. Starke
Kareem El Naamani
Rawad Abbas
Ossama Y. Mansour
Jorge Galvan
Joshua T. Billingsley
Abolghasem Mortazavi
Melanie Walker
Mahmoud Dibas
Fabio Settecase
Manraj K. S Heran
Anna L. Kuhn
Ajit S. Puri
Bijoy K. Menon
Sanjeev Sivakumar
Ashkan Mowla
Salvatore D'Amato
Alicia M. Zha
Daniel Cooke
Justin E. Vranic
Robert W. Regenhardt
James D. Rabinov
Christopher J. Stapleton
Mayank Goyal
Hannah Wu
Jake Cohen
David Turkel-Parella
Andrew Xavier
Muhammad Waqas
Vincent Tutino
Adnan Siddiqui
Gaurav Gupta
Anil Nanda
Priyank Khandelwal
Cristina Tiu
Pere C. Portela
Natalia Perez de la Ossa
Xabier Urra
Mercedes de Lera
Juan F. Arenillas
Marc Ribo
Manuel Requena
Mariangela Piano
Guglielmo Pero
Keith De Sousa
Fawaz Al-Mufti
Zafar Hashim
Sanjeev Nayak
Leonardo Renieri
Rose Du
Mohamed A. Aziz-Sultan
David Liebeskind
Raul G. Nogueira
Mohamad Abdalkader
Thanh N. Nguyen
Nicholas Vigilante
James E. Siegler
Jonathan A. Grossberg
Hassan Saad
Michael R. Gooch
Nabeel A. Herial
Robert H. Rosenwasser
Stavropoula Tjoumakaris
Aman B. Patel
Ambooj Tiwari
Pascal Jabbour

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Publication Title

European journal of neurology


BACKGROUND AND PURPOSE: Previous studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors.

METHODS: A cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted.

RESULTS: In this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID-19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID-19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23-0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12-0.77; p = 0.012). Moreover, endovascular complications, in-hospital mortality, and length of hospital stay were significantly higher among COVID-19 patients (p < 0.001).

CONCLUSION: COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID-19 patients with LVO were more often younger and had higher morbidity/mortality rates.

PubMed ID



ePub ahead of print