Long-Term Effect of Mechanical Thrombectomy in Stroke Patients According to Advanced Imaging Characteristics.

Beyeler, Morin; Pohle, Fabienne; Weber, Loris; Mueller, Madlaine; Kurmann, Christoph C; Mujanovic, Adnan; Clénin, Leander; Piechowiak, Eike Immo; Meinel, Thomas Raphael; Bücke, Philipp; Jung, Simon; Seiffge, David; Pilgram-Pastor, Sara M; Dobrocky, Tomas; Arnold, Marcel; Gralla, Jan; Fischer, Urs; Mordasini, Pasquale; Kaesmacher, Johannes (2024). Long-Term Effect of Mechanical Thrombectomy in Stroke Patients According to Advanced Imaging Characteristics. Clinical neuroradiology, 34(1), pp. 105-114. Springer-Verlag 10.1007/s00062-023-01337-4

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Data on long-term effect of mechanical thrombectomy (MT) in patients with large ischemic cores (≥ 70 ml) are scarce. Our study aimed to assess the long-term outcomes in MT-patients according to baseline advanced imaging parameters.


We performed a single-centre retrospective cohort study of stroke patients receiving MT between January 1, 2010 and December 31, 2018. We assessed baseline imaging to determine core and mismatch volumes and hypoperfusion intensity ratio (with low ratio reflecting good collateral status) using RAPID automated post-processing software. Main outcomes were cross-sectional long-term mortality, functional outcome and quality of life by May 2020. Analysis were stratified by the final reperfusion status.


In total 519 patients were included of whom 288 (55.5%) have deceased at follow-up (median follow-up time 28 months, interquartile range 1-55). Successful reperfusion was associated with lower long-term mortality in patients with ischemic core volumes ≥ 70 ml (adjusted hazard ratio (aHR) 0.20; 95% confidence interval (95% CI) 0.10-0.44) and ≥ 100 ml (aHR 0.26; 95% CI 0.08-0.87). The effect of successful reperfusion on long-term mortality was significant only in the presence of relevant mismatch (aHR 0.17; 95% CI 0.01-0.44). Increasing reperfusion grade was associated with a higher rate of favorable outcomes (mRS 0-3) also in patients with ischemic core volume ≥ 70 ml (aOR 3.58, 95% CI 1.64-7.83).


Our study demonstrated a sustainable benefit of better reperfusion status in patients with large ischemic core volumes. Our results suggest that patient deselection based on large ischemic cores alone is not advisable.

Item Type:

Journal Article (Original Article)


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

UniBE Contributor:

Beyeler, Morin, Weber, Loris, Müller, Madlaine, Kurmann, Christoph Carmelino, Mujanović, Adnan, Clénin, Leander Caspar, Piechowiak, Eike Immo, Meinel, Thomas Raphael, Bücke, Philipp Jonas, Jung, Simon, Seiffge, David Julian, Pilgram-Pastor, Sara Magdalena, Dobrocky, Tomas, Arnold, Marcel, Gralla, Jan, Fischer, Urs Martin, Mordasini, Pasquale Ranato, Kaesmacher, Johannes


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

30 Aug 2023 09:27

Last Modified:

22 Feb 2024 00:12

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PubMed ID:


Uncontrolled Keywords:

Hypoperfusion intensity ratio Ischemic core volume Long-term outcomes Mechanical thrombectomy Perfusion mismatch RAPID software





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