Group comparison according to the neurointerventionalist’s opinion on potential influence of vasospasm regarding the clinical outcome in patients with stroke after EVT (group 1: yes, vasospasm potentially influences the patient’s outcome, group 2: no, vasospasm does not influence the patient’s outcome)
| Group 1 N=281 | Group 2 N=253 | P value | |
|
Do you routinely give vasodilator (such as calcium channel blockers) during EVT to prevent vasospasm? N (%)
answered: 532, missing: 2 | |||
| No | 158 (56.23) | 166 (66.14) | 0.033 |
| Yes, add to guide catheter flush | 71 (25.27) | 55 (21.91) | 0.359 |
| Yes, add to intermediate catheter flush | 38 (13.52) | 20 (7.97) | 0.038 |
| Yes, add to microcatheter flush | 14 (4.98) | 10 (3.98) | 0.677 |
|
How often do you detect moderate-to-severe intracranial vasospasm during EVT for the treatment of LVO (large vessel occlusion) stroke, approximately? N (%)
answered: 526, missing: 8 | |||
| <5% | 114 (41.45) | 120 (47.81) | 0.117 |
| 5%–10% | 93 (33.82) | 61 (24.30) | 0.028 |
| 10%–15% | 42 (15.27) | 34 (13.55) | 0.71 |
| 15%–20% | 19 (6.91) | 25 (9.96) | 0.21 |
| >20% | 7 (2.55) | 11 (4.38) | 0.337 |
|
What do you consider as a relevant contraindication to medically treat vasospasm (with vasodilator) during EVT? N (%)
answered: 531, missing: 3 | |||
| Prolonged intervention time | 59 (21.07) | 38 (15.14) | 0.091 |
| Suspected extended infarction | 84 (60.0) | 50 (19.92) | 0.007 |
| Severe systemic hypotension | 188 (67.14) | 157 (62.55) | 0.277 |
| Bradycardia | 55 (19.64) | 57 (22.71) | 0.456 |
| None of the above | 38 (13.57) | 50 (19.92) | 0.034 |
| Other | 10 (3.57) | 12 (4.78) | 0.52 |
|
Do you continue with EVT in case of residual and amenable medium vessel occlusion when you observe a proximal vasospasm? N (%)
answered: 532, missing: 2 | |||
| Yes, I would continue immediately without treatment of the vasospasm | 27 (9.61) | 53 (21.12) | 0.008 |
| Yes, I would continue immediately but after initiating therapy with a vasodilator | 86 (30.60) | 68 (27.09) | 0.389 |
| Yes, I would continue but first wait until the vasospasm regressed substantially after treatment initiation | 132 (46.98) | 75 (29.88) | <0.001 |
| No, I wait until vasospasm has regressed spontaneously and then reassess | 36 (12.81) | 55 (21.91) | <0.001 |
|
Does a standard operating procedure exist at your facility on treating vasospasm during EVT? N (%)
answered: 531, missing: 3 | |||
| Yes | 90 (32.14) | 45 (17.93) | <0.001 |
Vasospasm-related questions.
significant p-values are in bold
EVT, endovascular stroke treatment.