Schnieder, Marlena

[["dc.bibliographiccitation.artnumber","e0216258"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","PLOS ONE"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Psychogios, Marios-Nikos"],["dc.contributor.author","Tsogkas, Ioannis"],["dc.contributor.author","Brehm, Alex"],["dc.contributor.author","Hesse, Amelie"],["dc.contributor.author","McTaggart, Ryan"],["dc.contributor.author","Goyal, Mayank"],["dc.contributor.author","Maier, Ilko"],["dc.contributor.author","Schnieder, Marlena"],["dc.contributor.author","Behme, Daniel"],["dc.contributor.author","Maus, Volker"],["dc.date.accessioned","2019-07-09T11:51:31Z"],["dc.date.available","2019-07-09T11:51:31Z"],["dc.date.issued","2019"],["dc.description.abstract","INTRODUCTION: The \"Stent retriever Assisted Vacuum-locked Extraction\" (SAVE) technique is a promising embolectomy method for intracranial large vessel occlusion (LVO). We report our experience using a modified SAVE (mSAVE) approach for clot reduction prior to embolectomy in acute ischemic stroke patients with large clots. MATERIALS AND METHODS: We retrospectively analyzed 20 consecutive patients undergoing mSAVE in our center due to intracranial LVO. Angiographic data (including first-pass and overall complete reperfusion, defined as an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 3, rate of successful reperfusion (eTICI ≥2c), number of passes, time from groin puncture to reperfusion) and clinical data (favorable outcome at 90 days, defined as modified Rankin Scale (mRS) ≤2) were assessed. RESULTS: First-pass and overall eTICI 3 reperfusion was reached in 13/20 (65%) and 14/20 (70%), respectively. The rate of successful reperfusion (eTICI ≥2c) after one pass was 85% and on final angiogram 90% with an average number of 1.1 ± 0.3 attempts. Eight out of 11 (73%) ICA occlusions were reperfused successfully and 5 (46%) completely after a single pass. Median groin to reperfusion time was 33 minutes (IQR 25-46). A favorable clinical outcome was achieved in 9/20 (45%) patients at discharge and after 90 days, respectively. CONCLUSION: Clot reduction followed by embolectomy (mSAVE) is feasible and may be an important tool in the treatment of large clots."],["dc.identifier.doi","10.1371/journal.pone.0216258"],["dc.identifier.pmid","31071109"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16142"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59962"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.title","Clot reduction prior to embolectomy: mSAVE as a first-line technique for large clots"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","e0196174"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","PLoS One"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Maier, Ilko L."],["dc.contributor.author","Becker, Johannes C."],["dc.contributor.author","Leyhe, Johanna Rosemarie"],["dc.contributor.author","Schnieder, Marlena"],["dc.contributor.author","Behme, Daniel"],["dc.contributor.author","Psychogios, Marios-Nikos"],["dc.contributor.author","Liman, Jan"],["dc.date.accessioned","2019-07-09T11:45:41Z"],["dc.date.available","2019-07-09T11:45:41Z"],["dc.date.issued","2018"],["dc.description.abstract","BACKGROUND: Stroke-induced immunodepression is a well characterized complication of acute ischemic stroke. In experimental studies beta-blocker therapy reversed stroke-induced immunodepression, reduced infection rates and mortality. Recent, heterogeneous studies in stroke patients could not provide evidence of a protective effect of beta-blocker therapy. Aim of this study is to investigate the potential preventive effect of beta-blockers in subgroups of patients at high risk for stroke-induced immunodepression. METHODS: Data from a prospectively derived registry of major stroke patients receiving endovascular therapy between 2011-2017 in a tertiary stroke center (University Medical Center Göttingen. Germany) was used. The effect of beta-blocker therapy on pneumonia, urinary tract infection, sepsis and mortality was assessed using multivariate logistic regression analysis. RESULTS: Three hundred six patients with a mean age of 72 ± 13 years and a median NIHSS of 16 (IQR 10.75-20) were included. 158 patients (51.6%) had pre-stroke- and continued beta-blocker therapy. Beta-blocker therapy did not reduce the incidence of pneumonia (OR 0.78, 95% CI 0.31-1.92, p = 0.584), urinary tract infections (OR 1.51, 0.88-2.60, p = 0.135), sepsis (OR 0.57, 0.18-1.80, p = 0.334) or mortality (OR 0.59, 0.16-2.17, p = 0.429). Strokes involving the insula and anterio-medial cortex increased the risk for pneumonia (OR 4.55, 2.41-8.56, p<0.001) and sepsis (OR 4.13, 1.81-9.43, p = 0.001), while right hemispheric strokes increased the risk for pneumonia (OR 1.60, 0.92-2.77, p = 0.096). There was a non-significantly increased risk for urinary tract infections in patients with beta-blocker therapy and insula/anterio-medial cortex strokes (OR 3.12, 95% CI 0.88-11.05, p = 0.077) with no effect of beta-blocker therapy on pneumonia, sepsis or mortality in both subgroups. CONCLUSIONS: In major ischemic stroke patients, beta-blocker therapy did not lower post-stroke infection rates and was associated with urinary tract infections in a subgroup with insula/anterio-medial strokes."],["dc.identifier.doi","10.1371/journal.pone.0196174"],["dc.identifier.pmid","29694433"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15285"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59286"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.issn","1932-6203"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.subject.mesh","Adrenergic beta-Antagonists"],["dc.subject.mesh","Aged"],["dc.subject.mesh","Aged, 80 and over"],["dc.subject.mesh","Death"],["dc.subject.mesh","Female"],["dc.subject.mesh","Humans"],["dc.subject.mesh","Incidence"],["dc.subject.mesh","Male"],["dc.subject.mesh","Middle Aged"],["dc.subject.mesh","Pneumonia"],["dc.subject.mesh","Prospective Studies"],["dc.subject.mesh","Registries"],["dc.subject.mesh","Sepsis"],["dc.subject.mesh","Stroke"],["dc.subject.mesh","Tertiary Care Centers"],["dc.subject.mesh","Urinary Tract Infections"],["dc.title","Influence of beta-blocker therapy on the risk of infections and death in patients at high risk for stroke induced immunodepression"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]