Eberhard Karl University of Tuebingen
Neurology & Stroke
Since November 2021, I am working as a senior physician at the University Hospital Tübingen (UKT), Department of Neurology & Stroke. I am responsible for the stroke unit, IMC, ICU and the emergency department. I did my residency starting in February 2011 in the university hospital of Munich (LMU) and completed my training in February 2019. During my training, I was primarily employed in neurological acute and intensive care. From December 2019 until October 2020, I was working in telemedicine for the Neurovascular Network of Southwest Bavaria (NEVAS). Scientifically, I first worked in the research group of Prof. Dr. M. Strupp on dizziness and balance disorders, especially vestibular and cerebellar disorders and their treatment options. I completed my habilitation in neurology on the topic "Improvement of the diagnosis of vertigo syndromes and therapy of cerebellar vertigo disorders" in March 2020. In the context of this scientific occupation, I raised a BMBF grant of 1,044,865 EUR for the now completed, multicenter, international ALCAT study (grant number: 01KG1422). However, as my clinical focus was - as mentioned above - mainly in acute/emergency and intensive care medicine, I decided to establish an additional scientific focus in vascular medicine (working group of Prof. Dr. L. Kellert). In the meantime, I have also published very successfully in this field, regarding the acute treatment options in stroke including intravenous thrombolysis, mechanical thrombectomy and clinical factors for success and outcome. Further funding I have obtained was in the context of a - currently ongoing - monocentric study on the efficacy of ipad-based speech therapy after stroke ("Lexi Study", funding amount 10.000 € by Boehringer Ingelheim).

Presenter of 1 Presentation

MINOR STROKES WITH LARGE VESSEL OCCLUSION: A MATCHED ANALYSIS FROM THE GERMAN STROKE REGISTRY-ENDOVASCULAR TREATMENT(GSR-ET) AND THE SAFE IMPLEMENTATION OF THROMBOLYSIS IN STROKE REGISTRY (SITS)

Session Type
Free Communication Session
Date
29.10.2021, Friday
Session Time
15:15 - 16:45
Room
FREE COMMUNICATIONS A
Lecture Time
15:55 - 16:05

Abstract

Background and Aims

Treatment of large vessel occlusion (LVO) in patients presenting with mild neurological deficits (minor strokes with NIHSS ≤ 5) is still a matter of debate. The main purpose of this study was to compare the outcome of LVO-minor stroke patients treated with intravenous thrombolysis(IVT) plus/minus mechanical thrombectomy(MT).

Methods

GSR-ET and SITS-registry patients enrolled between 06/2015 and 12/2019 were analyzed. Minor stroke patients due to LVO were compared using propensity score matching (PSM). Primary outcomes were the safety, technical and clinical efficacy of IVT plus/minus MT including the technical angiographic outcome parameters (successful reperfusion using the modified Thrombolysis In Cerebral Infarction (mTICI) score of 2b-3) and good functional outcome at 3-months follow-up (modified Rankin Scale (mRS) of 0-2).

Results

Among 6635 GSR-patients, a total of 676 (9.6%) presented with minor strokes. Among these, 272GSR-ET-patients – all IVT-treated (age 68.6±14.0 years, 43.4%female, premorbid mRS (pmRS) 0 (0-0), NIHSS 4 (2-5)) were compared to 272 SITS-patients(69.4±13.7, 43.4% female, pmRS 0 (0-0), NIHSS 4 (2-5)). Successful reperfusion in GSR-ET-patients was achieved in 81.6%. Good functional outcome (67.3% versus 69.5%, p=0.795), mortality (5.1% versus 6.6%, p=0.207) and intracranial hemorrhage (12.5% versus 8.8%, p=0.308) were comparable. After PSM for 624 GSR-ET-patients (IVT-rate 56.7%) and 624 SITS-patients (IVT-rate 100%) independent predictors for good outcome were age, pmRS, NIHSS, IVT-treatment and occurrence of ICH.

Conclusions

Our study demonstrates similar effectiveness of IVT alone compared to MT plus/minus IVT in minor stroke patients. There is an urgent need for randomized controlled trials in this stroke field, including imaging parameters.

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