Stent-Based Retrieval Techniques in Acute Ischemic Stroke Patients with and Without Susceptibility Vessel Sign.

Belachew, Nebiyat F.; Piechowiak, Eike I.; Dobrocky, Tomas; Meinel, Thomas Raphael; Hakim, Arsany; Barvulsky, Enrique A.; Vynckier, Jan; Arnold, Marcel; Seiffge, David J.; Wiest, Roland; Fischer, Urs; Gralla, Jan; Kaesmacher, Johannes; Mordasini, Pasquale (2021). Stent-Based Retrieval Techniques in Acute Ischemic Stroke Patients with and Without Susceptibility Vessel Sign. (In Press). Clinical neuroradiology Springer-Verlag 10.1007/s00062-021-01079-1

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BACKGROUND AND PURPOSE

Randomized controlled trials have challenged the assumption that reperfusion success after mechanical thrombectomy varies depending on the retrieval techniques applied; however, recent analyses have suggested that acute ischemic stroke (AIS) patients showing susceptibility vessel sign (SVS) may respond differently. We aimed to compare different stent retriever (SR)-based thrombectomy techniques with respect to interventional outcome parameters depending on SVS status.

METHODS

We retrospectively reviewed 497 patients treated with SR-based thrombectomy for anterior circulation AIS. Imaging was conducted using a 1.5 T or 3 T magnetic resonance imaging (MRI) scanner. Logistic regression analyses were performed to test for the interaction of SVS status and first-line retrieval technique. Results are shown as percentages, total values or adjusted odds ratio (aOR) with 95% confidence intervals (CI).

RESULTS

An SVS was present in 87.9% (n = 437) of patients. First-line SR thrombectomy was used to treat 293 patients, whereas 204 patients were treated with a combined approach (COA) of SR and distal aspiration. An additional balloon-guide catheter (BGC) was used in 273 SR-treated (93.2%) and 89 COA-treated (43.6%) patients. On logistic regression analysis, the interaction variable of SVS status and first-line retrieval technique was not associated with first-pass reperfusion (aOR 1.736, 95% CI 0.491-6.136; p = 0.392), overall reperfusion (aOR 3.173, 95% CI 0.752-13.387; p = 0.116), periinterventional complications, embolization into new territories, or symptomatic intracerebral hemorrhage. The use of BGC did not affect the results.

CONCLUSION

While previous analyses indicated that first-line SR thrombectomy may promise higher rates of reperfusion than contact aspiration in AIS patients with SVS, our data show no superiority of any particular SR-based retrieval technique regardless of SVS status.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Belachew, Nebiyat Filate; Piechowiak, Eike Immo; Dobrocky, Tomas; Meinel, Thomas Raphael; Hakim, Arsany; Barvulsky Alemán, MD, Enrique Eduardo; Vynckier, Jan Luc; Arnold, Marcel; Seiffge, David Julian; Wiest, Roland; Fischer, Urs; Gralla, Jan; Kaesmacher, Johannes and Mordasini, Pasquale

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1869-1439

Publisher:

Springer-Verlag

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

22 Sep 2021 13:22

Last Modified:

24 Sep 2021 07:16

Publisher DOI:

10.1007/s00062-021-01079-1

PubMed ID:

34463776

Uncontrolled Keywords:

Clot characteristics MRI Reperfusion Stent retriever Thrombectomy

BORIS DOI:

10.48350/159139

URI:

https://boris.unibe.ch/id/eprint/159139

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