Endovascular Thrombectomy Peri-Procedural Recall: A Mixed Methods Study

<p>Purpose: This study aimed to explore patient characteristics and recollection of the peri-procedural endovascular thrombectomy (EVT) phase for individuals diagnosed with large vessel occlusion (LVO) stroke. Methods: A convergent mixed methods study was conducted to understand the lived experience of individuals receiving EVT intervention for LVO stroke. The relationship between patient recollection of the peri-procedural EVT period and LVO characteristics was explored. Stroke survivors participated in semi-structured interviews during acute hospitalization and completed the PHQ-9 and PSS-I-5 to assess potential psychological consequences of their life-threatening event and neurointerventional treatment. Results: A total of 20 patients participated in the study; 45% recalled the peri-procedural EVT period despite receiving conscious sedation; and a body mass index (BMI) > 30 (obesity) was significantly associated with recollection (p = 0.025). Recall of EVT was not associated with either depression or post-traumatic stress disorder (PTSD) symptoms. Higher National Institutes of Health Stroke Scale (NIHSS) scores were associated with increased odds of depressive symptoms 24-hour post-EVT (OR = 8.33; 95% CI = 1.034-67.142) and at discharge or day 7 (OR = 13.55; 95% CI = 1.197-152.211). Patients with higher NIHSS scores also had increased odds of PTSD symptoms 24-hour post-EVT (OR = 21; 95% CI = 1.777-248.103) and at discharge or day 7 (OR = 16; 95% CI = 1.788-143.150). Qualitative data revealed three key themes regarding survivor experiences, converging with quantitative findings to show that obese patients were more likely to have procedural memory and those with persistent neurologic disability were more likely to experience depression and PTSD. Conclusion: Peri-procedural EVT recall is a multifactorial phenomenon influenced by patient BMI despite sedation, but is not associated with depression or PTSD. Patients with higher NIHSS disability have increased odds of early depression and PTSD. Tailored BMI-driven conscious sedation protocols should be evaluated to determine their impact on EVT recall. Future observational research is needed to confirm these findings in larger cohorts using objective recall measures to better understand this population's needs and inform targeted interventions.</p>

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Nursing Science

Year dc:date.available

2025

Author dc:creator

• Barve, Sarah Nicole

Contributors dc:contributor

• Anne Alexandrov

• acute ischemic stroke
• endovascular thrombectomy
• large vessel occlusion
• mixed methods research
• stroke outcomes
• stroke survivor experiences
• Medicine and Health Sciences
• Nursing

Repository record dc:identifier

https://dc.uthsc.edu/dissertations/723

OAI identifier oai:identifier

oai:dc.uthsc.edu:dissertations-1723