First Pass Effect With Neurothrombectomy for Acute Ischemic Stroke: Analysis of the Systematic Evaluation of Patients Treated With Stroke Devices for Acute Ischemic Stroke Registry.
Stroke
; 53(2): e30-e32, 2022 02.
Article
em En
| MEDLINE
| ID: mdl-34784741
BACKGROUND AND PURPOSE: Achieving complete revascularization after a single pass of a mechanical thrombectomy device (first pass effect [FPE]) is associated with good clinical outcomes in patients with acute ischemic stroke due to large vessel occlusion. We assessed patient characteristics, outcomes, and predictors of FPE among a large real-world cohort of patients (Systematic Evaluation of Patients Treated with Stroke Devices for Acute Ischemic Stroke registry). METHODS: Demographics, clinical outcomes, and procedural characteristics were analyzed among patients in whom FPE (modified Thrombolysis in Cerebral Infarction 2c/3 after first pass) was achieved versus those requiring multiple passes (MP). Modified FPE and modified MP included patients achieving modified Thrombolysis in Cerebral Infarction 2B-3. Primary outcomes included 90-day modified Rankin Scale (mRS) score and mortality. RESULTS: Among 984 Systematic Evaluation of Patients Treated with Stroke Devices for Acute Ischemic Stroke patients, 930 had complete 90-day follow-up. FPE was achieved in 40.5% (377/930) of patients and MP in 20.0% (186/930). Baseline characteristics were similar across all groups. The FPE group had fewer internal carotid artery occlusions compared with MP (P=0.029). The FPE group had faster puncture to recanalization time (P≤0.001), higher rates of 90-day mRS score of 0 to 1 (52.6% versus 38.6%, P=0.003), mRS score of 0 to 2 (65.4% versus 52.0%, P=0.003), and lower 90-day mortality compared with the MP group (12.0% versus 18.7%, P=0.038). Similarly, compared with modified MP patients, the modified FPE group had fewer internal carotid artery occlusions (P=0.004), faster puncture to recanalization time (P≤0.001), and higher rates of 90-day mRS score of 0 to 1 (P=0.002) and mRS score of 0 to 2 (P=0.003). CONCLUSIONS: Our findings demonstrate that FPE and modified FPE are associated with superior clinical outcomes.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trombectomia
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Acidente Vascular Cerebral
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AVC Isquêmico
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Stroke
Ano de publicação:
2022
Tipo de documento:
Article