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 (2022). Stent-Based Retrieval Techniques in Acute Ischemic Stroke Patients with and Without Susceptibility Vessel Sign. Clinical neuroradiology, 32(2), pp. 407-418. 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 Gerhard Rudi, Fischer, Urs Martin, Gralla, Jan, Kaesmacher, Johannes, Mordasini, Pasquale Ranato

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:

02 Mar 2023 23:35

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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