Recanalization Rate per Retrieval Attempt in Mechanical Thrombectomy for Acute Ischemic Stroke
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Recanalization Rate per Retrieval Attempt in Mechanical Thrombectomy for Acute Ischemic Stroke. / Flottmann, Fabian; Leischner, Hannes; Broocks, Gabriel; Nawabi, Jawed; Bernhardt, Martina; Faizy, Tobias; Deb-Chatterji, Milani; Thomalla, Götz; Fiehler, Jens; Brekenfeld, Caspar.
in: STROKE, Jahrgang 49, Nr. 10, 07.09.2018, S. 2523-2525.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Recanalization Rate per Retrieval Attempt in Mechanical Thrombectomy for Acute Ischemic Stroke
AU - Flottmann, Fabian
AU - Leischner, Hannes
AU - Broocks, Gabriel
AU - Nawabi, Jawed
AU - Bernhardt, Martina
AU - Faizy, Tobias
AU - Deb-Chatterji, Milani
AU - Thomalla, Götz
AU - Fiehler, Jens
AU - Brekenfeld, Caspar
PY - 2018/9/7
Y1 - 2018/9/7
N2 - Background and Purpose: In acute ischemic stroke, mechanical thrombectomy allows flow restoration in the majority of cases. In case of an unsuccessful retrieval, little is known about how many retrieval attempts should be performed before stopping the procedure. This study assessed the recanalization rate and clinical outcome per retrieval maneuver.Methods: In this analysis, 330 patients with acute large vessel occlusion treated exclusively with stentrieval devices were included. Successful recanalization was defined as Thrombolysis in Cerebral Infarction 2b-3, a good clinical outcome was defined as modified Rankin Scale at 90 days of ≤2.Results: The median number of retrieval attempts was 1 (interquartile range, 1–2, maximum 8). Recanalization rates per retrieval attempt were highest for the first retrieval (46.8%) and lowest for the fifth retrieval (22.7%). After 3 retrieval attempts, 67.9% of patients were successfully recanalized. Patients with 1 to 3 retrieval attempts had higher rates of good clinical outcome (28.9% versus 7.4%; P=0.018). The number of passes was an independent negative predictor of good clinical outcome (adjusted odds ratio, 0.65; 95% CI, 0.435–0.970; P=0.035).Conclusions: Two-thirds of occlusions were successfully recanalized with up to 3 retrieval attempts. Further attempts had good recanalization rates, but the rate of favorable clinical outcome did not improve.
AB - Background and Purpose: In acute ischemic stroke, mechanical thrombectomy allows flow restoration in the majority of cases. In case of an unsuccessful retrieval, little is known about how many retrieval attempts should be performed before stopping the procedure. This study assessed the recanalization rate and clinical outcome per retrieval maneuver.Methods: In this analysis, 330 patients with acute large vessel occlusion treated exclusively with stentrieval devices were included. Successful recanalization was defined as Thrombolysis in Cerebral Infarction 2b-3, a good clinical outcome was defined as modified Rankin Scale at 90 days of ≤2.Results: The median number of retrieval attempts was 1 (interquartile range, 1–2, maximum 8). Recanalization rates per retrieval attempt were highest for the first retrieval (46.8%) and lowest for the fifth retrieval (22.7%). After 3 retrieval attempts, 67.9% of patients were successfully recanalized. Patients with 1 to 3 retrieval attempts had higher rates of good clinical outcome (28.9% versus 7.4%; P=0.018). The number of passes was an independent negative predictor of good clinical outcome (adjusted odds ratio, 0.65; 95% CI, 0.435–0.970; P=0.035).Conclusions: Two-thirds of occlusions were successfully recanalized with up to 3 retrieval attempts. Further attempts had good recanalization rates, but the rate of favorable clinical outcome did not improve.
U2 - 10.1161/STROKEAHA.118.022737
DO - 10.1161/STROKEAHA.118.022737
M3 - SCORING: Zeitschriftenaufsatz
VL - 49
SP - 2523
EP - 2525
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 10
ER -