{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:52:00Z","timestamp":1777510320311,"version":"3.51.4"},"reference-count":17,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: New therapies like intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) for acute ischemic stroke (AIS) can significantly impact outcomes and complication rates. This study examines the nationwide impact of MT implementation on decompressive hemicraniectomy (DH) in Germany, accounting for the effects of the COVID-19 pandemic. Methods: Annual treatment numbers (2015 to 2023) for IVT, MT, DH, cranioplasty (CP), and Computer-Aided Design CP (CAD CP) were extracted using the Operation and Procedure Codes (OPS). Age and sex distributions were analysed in four age groups (0\u201339, 40\u201359, 60\u201379, \u226580 years). Hospitalizations for AIS, subarachnoid haemorrhage (SAH), and intracranial haemorrhage (ICH) were included. Annual treatment rates were calculated. Results: In 2015 250,802 patients with AIS, 11,082 patients with SAH and 47,336 patients with ICH were documented. Overall, AIS hospitalizations declined slightly by 1.1%, whereas SAH and ICH decreased more markedly by 15.6% and 14.3%, respectively, with the most pronounced reductions observed during the COVID-19 pandemic. Among AIS patients, intravenous thrombolysis increased from 16% to 20%, while mechanical thrombectomy rates increased from 3% to 9%. Both reperfusion therapies showed increasing use particularly among patients aged \u226580 years (IVT: +35%; MT: +42%). DH remained overall stable (+2.82%), with a predominance in men (60%). In contrast, CP procedures declined by 25.3%, whereas CAD CP increased by 35% during the observation period. Conclusions: Long-term increasing trends in reperfusion therapies, especially mechanical thrombectomy, were largely unaffected by the COVID-19 pandemic and\u2014contrary to expectation\u2014obviously had no influence on the emergence of decompressive hemicraniectomy in our descriptive analysis.<\/jats:p>","DOI":"10.3390\/brainsci16050444","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T12:04:42Z","timestamp":1776945882000},"page":"444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends of Major Cerebrovascular Procedures After Mechanical Thrombectomy Implementation: A Nationwide Observational Study in Germany (2015\u20132023)"],"prefix":"10.3390","volume":"16","author":[{"given":"Sara","family":"Hirsch","sequence":"first","affiliation":[{"name":"Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-7227","authenticated-orcid":false,"given":"Karel","family":"Kostev","sequence":"additional","affiliation":[{"name":"Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Hammed","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bert","family":"Bosche","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ev. Hospital Mettmann, 40822 Mettmann, Germany"},{"name":"Department of Neurology, University Hospital Essen, Medical Faculty, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Molcanyi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mediclin Hospital Reichshof, 51580 Reichshof-Eckenhagen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Tanislav","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.molonc.2014.10.003","article-title":"Assessment of benefits and risks in development of targeted therapies for cancer\u2014The view of regulatory authorities","volume":"9","author":"Pignatti","year":"2015","journal-title":"Mol. 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