{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:43:10Z","timestamp":1789699390621,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Vasospasm is a common iatrogenic event during mechanical thrombectomy (MT). In such circumstances, intra\u2010arterial nimodipine administration is occasionally considered. However, its use in the treatment of iatrogenic vasospasm during MT has been poorly studied. We investigated the impact of iatrogenic vasospasm treated with intra\u2010arterial nimodipine on outcomes after MT for large vessel occlusion stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of the multicenter observational registry Endovascular Treatment in Ischemic Stroke (ETIS). Consecutive patients treated with MT between January 2015 and December 2022 were included. Patients treated with medical treatment alone, without MT, were excluded. We also excluded patients who received another in\u00a0situ vasodilator molecule during the procedure. Outcomes were compared according to the occurrence of cervical and\/or intracranial arterial vasospasm requiring intraoperative use of in\u00a0situ nimodipine based on operator's decision, using a propensity score approach. The primary outcome was a modified Rankin Scale (mRS) score of 0\u20132 at 90\u2009days. Secondary outcomes included excellent outcome (mRS score 0\u20131), final recanalization, mortality, intracranial hemorrhage and procedural complications. Secondary analyses were performed according to the vasospasm location (intracranial or cervical).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 13,678 patients in the registry during the study period, 434 received intra\u2010arterial nimodipine for the treatment of MT\u2010related vasospasm. In the main analysis, comparable odds of favorable outcome were observed, whereas excellent outcome was significantly less frequent in the group with vasospasm requiring nimodipine (adjusted odds ratio [aOR]\u20090.78, 95% confidence interval [CI] 0.63\u20130.97). Perfect recanalization, defined as a final modified Thrombolysis In Cerebral Infarction score of 3 (aOR\u20090.63, 95% CI 0.42\u20130.93), was also rarer in the vasospasm group. Intracranial vasospasm treated with nimodipine was significantly associated with worse clinical outcome (aOR 0.64, 95% CI 0.45\u20130.92), in contrast to the cervical location (aOR\u20091.37, 95% CI 0.54\u20133.08).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Arterial vasospasm occurring during the MT procedure and requiring intra\u2010arterial nimodipine administration was associated with worse outcomes, especially in case of intracranial vasospasm. Although this study cannot formally differentiate whether the negative consequences were due to the vasospasm itself, or nimodipine administration or both, there might be an important signal toward a substantial clinical impact of iatrogenic vasospasm during MT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16467","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T05:15:38Z","timestamp":1725858938000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Iatrogenic arterial vasospasm during mechanical thrombectomy requiring treatment with intra\u2010arterial nimodipine might be associated with worse outcomes"],"prefix":"10.1111","volume":"31","author":[{"given":"Serine","family":"Ferhat","sequence":"first","affiliation":[{"name":"Neuroradiology Department Bordeaux University Hospital  Bordeaux 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