@article{FabritiusWoelferHerzbergetal.2021, author = {Fabritius, Matthias Philipp and W{\"o}lfer, Teresa A. and Herzberg, Moriz and Tiedt, Steffen and Puhr-Westerheide, Daniel and Grosu, Sergio and Maurus, Stefan and Geyer, Thomas and Curta, Adrian and Kellert, Lars and K{\"u}pper, Clemens and Liebig, Thomas and Ricke, Jens and Dimitriadis, Konstantinos and Kunz, Wolfgang G. and Zimmermann, Hanna and Reidler, Paul}, title = {Course of early neurologic symptom severity after endovascular treatment of anterior circulation large vessel occlusion stroke: association with baseline multiparametric CT imaging and clinical parameters}, series = {Diagnostics}, volume = {11}, journal = {Diagnostics}, number = {7}, issn = {2075-4418}, doi = {10.3390/diagnostics11071272}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242681}, year = {2021}, abstract = {Background: Neurologic symptom severity and deterioration at 24 hours (h) predict long-term outcomes in patients with acute large vessel occlusion (LVO) stroke of the anterior circulation. We aimed to examine the association of baseline multiparametric CT imaging and clinical factors with the course of neurologic symptom severity in the first 24 h after endovascular treatment (EVT). Methods: Patients with LVO stroke of the anterior circulation were selected from a prospectively acquired consecutive cohort of patients who underwent multiparametric CT, including non-contrast CT, CT angiography and CT perfusion before EVT. The symptom severity was assessed on admission and after 24 h using the 42-point National Institutes of Health Stroke Scale (NIHSS). Clinical and imaging data were compared between patients with and without early neurological deterioration (END). END was defined as an increase in ≥4 points, and a significant clinical improvement as a decrease in ≥4 points, compared to NIHSS on admission. Multivariate regression analyses were used to determine independent associations of imaging and clinical parameters with NIHSS score increase or decrease in the first 24 h. Results: A total of 211 patients were included, of whom 38 (18.0\%) had an END. END was significantly associated with occlusion of the internal carotid artery (odds ratio (OR), 4.25; 95\% CI, 1.90-9.47) and the carotid T (OR, 6.34; 95\% CI, 2.56-15.71), clot burden score (OR, 0.79; 95\% CI, 0.68-0.92) and total ischemic volume (OR, 1.01; 95\% CI, 1.00-1.01). In a comprehensive multivariate analysis model including periprocedural parameters and complications after EVT, carotid T occlusion remained independently associated with END, next to reperfusion status and intracranial hemorrhage. Favorable reperfusion status and small ischemic core volume were associated with clinical improvement after 24 h. Conclusions: The use of imaging parameters as a surrogate for early NIHSS progression in an acute LVO stroke after EVT reached limited performance with only carotid T occlusion as an independent predictor of END. Reperfusion status and early complications in terms of intracranial hemorrhage are critical factors that influence patient outcome in the acute stroke phase after EVT.}, language = {en} } @article{HerzbergScherlingStahletal.2021, author = {Herzberg, Moritz and Scherling, Korbinian and Stahl, Robert and Tiedt, Steffen and Wollenweber, Frank A. and K{\"u}pper, Clemens and Feil, Katharina and Forbrig, Robert and Patzig, Maximilian and Kellert, Lars and Kunz, Wolfgang G. and Reidler, Paul and Zimmermann, Hanna and Liebig, Thomas and Dieterich, Marianne and Dorn, Franziska}, title = {Late Thrombectomy in Clinical Practice: Retrospective Application of DAWN/DEFUSE3 Criteria within the German Stroke Registry}, series = {Clinical Neuroradiology}, volume = {31}, journal = {Clinical Neuroradiology}, number = {3}, doi = {10.1007/s00062-021-01033-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264765}, pages = {799-810}, year = {2021}, abstract = {Background and Purpose To provide real-world data on outcome and procedural factors of late thrombectomy patients. Methods We retrospectively analyzed patients from the multicenter German Stroke Registry. The primary endpoint was clinical outcome on the modified Rankin scale (mRS) at 3 months. Trial-eligible patients and the subgroups were compared to the ineligible group. Secondary analyses included multivariate logistic regression to identify predictors of good outcome (mRS ≤ 2). Results Of 1917 patients who underwent thrombectomy, 208 (11\%) were treated within a time window ≥ 6-24 h and met the baseline trial criteria. Of these, 27 patients (13\%) were eligible for DAWN and 39 (19\%) for DEFUSE3 and 156 patients were not eligible for DAWN or DEFUSE3 (75\%), mainly because there was no perfusion imaging (62\%; n = 129). Good outcome was not significantly higher in trial-ineligible (27\%) than in trial-eligible (20\%) patients (p = 0.343). Patients with large trial-ineligible CT perfusion imaging (CTP) lesions had significantly more hemorrhagic complications (33\%) as well as unfavorable outcomes. Conclusion In clinical practice, the high number of patients with a good clinical outcome after endovascular therapy ≥ 6-24 h as in DAWN/DEFUSE3 could not be achieved. Similar outcomes are seen in patients selected for EVT ≥ 6 h based on factors other than CTP. Patients triaged without CTP showed trends for shorter arrival to reperfusion times and higher rates of independence.}, language = {en} } @article{HerzbergDornTrummetal.2022, author = {Herzberg, Moriz and Dorn, Franziska and Trumm, Christoph and Kellert, Lars and Tiedt, Steffen and Feil, Katharina and K{\"u}pper, Clemens and Wollenweber, Frank and Liebig, Thomas and Zimmermann, Hanna}, title = {Middle cerebral artery M2 thrombectomy: safety and technical considerations in the German Stroke Registry (GSR)}, series = {Journal of Clinical Medicine}, volume = {11}, journal = {Journal of Clinical Medicine}, number = {15}, issn = {2077-0383}, doi = {10.3390/jcm11154619}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-286052}, year = {2022}, abstract = {There is ongoing debate concerning the safety and efficacy of various mechanical thrombectomy (MT) approaches for M2 occlusions. We compared these for MT in M2 versus M1 occlusions. Subgroup analyses of different technical approaches within the M2 MT cohort were also performed. Patients were included from the German Stroke Registry (GSR), a multicenter registry of consecutive MT patients. Primary outcomes were reperfusion success events. Secondary outcomes were early clinical improvement (improvement in NIHSS score > 4) and independent survival at 90 days (mRS 0-2). Out of 3804 patients, 2689 presented with M1 (71\%) and 1115 with isolated M2 occlusions (29\%). The mean age was 76 (CI 65-82) and 77 (CI 66-83) years, respectively. Except for baseline NIHSS (15 (CI 10-18) vs. 11 (CI 6-16), p < 0.001) and ASPECTS (9 (CI 7-10) vs. 9 (CI 8-10, p < 0.001), baseline demographics were balanced. Apart from a more frequent use of dedicated small vessel stent retrievers (svSR) in M2 (17.4\% vs. 3.0; p < 0.001), intraprocedural aspects were balanced. There was no difference in ICH at 24 h (11\%; p = 1.0), adverse events (14.4\% vs. 18.1\%; p = 0.63), clinical improvement (62.5\% vs. 61.4 \%; p = 0.57), mortality (26.9\% vs. 22.9\%; p = 0.23). In M2 MT, conventional stent retriever (cSR) achieved higher rates of mTICI3 (54.0\% vs. 37.7-42.0\%; p < 0.001), requiring more MT-maneuvers (7, CI 2-8) vs. 2 (CI 2-7)/(CI 2-2); p < 0.001) and without impact on efficacy and outcome. Real-life MT in M2 can be performed with equal safety and efficacy as in M1 occlusions. Different recanalization techniques including the use of svSR did not result in significant differences regarding safety, efficacy and outcome.}, language = {en} } @article{MorisChristmannWirtgenetal.2021, author = {Moris, Victoria C. and Christmann, Katharina and Wirtgen, Aline and Belokobylskij, Sergey A. and Berg, Alexander and Liebig, Wolf-Harald and Soon, Villu and Baur, Hannes and Schmitt, Thomas and Niehuis, Oliver}, title = {Cuticular hydrocarbons on old museum specimens of the spiny mason wasp, Odynerus spinipes (Hymenoptera: Vespidae: Eumeninae), shed light on the distribution and on regional frequencies of distinct chemotypes}, series = {Chemoecology}, volume = {31}, journal = {Chemoecology}, number = {5}, issn = {0937-7409}, doi = {10.1007/s00049-021-00350-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-306999}, pages = {311-322}, year = {2021}, abstract = {The mason wasp Odynerus spinipes shows an exceptional case of intrasexual cuticular hydrocarbon (CHC) profile dimorphism. Females of this species display one of two CHC profiles (chemotypes) that differ qualitatively and quantitatively from each other. The ratio of the two chemotypes was previously shown to be close to 1:1 at three sites in Southern Germany, which might not be representative given the Palearctic distribution of the species. To infer the frequency of the two chemotypes across the entire distributional range of the species, we analyzed with GC-MS the CHC profile of 1042 dry-mounted specimens stored in private and museum collections. We complemented our sampling by including 324 samples collected and preserved specifically for studying their CHCs. We were capable of reliably identifying the chemotypes in 91\% of dry-mounted samples, some of which collected almost 200 years ago. We found both chemotypes to occur in the Far East, the presumed glacial refuge of the species, and their frequency to differ considerably between sites and geographic regions. The geographic structure in the chemotype frequencies could be the result of differential selection regimes and/or different dispersal routes during the colonization of the Western Palearctic. The presented data pave the route for disentangling these factors by providing information where to geographically sample O. spinipes for population genetic analyses. They also form the much-needed basis for future studies aiming to understand the evolutionary and geographic origin as well as the genetics of the astounding CHC profile dimorphism that O. spinipes females exhibit.}, language = {en} }