Impact of thrombus surface on first pass reperfusion in contact aspiration and stent retriever thrombectomy.

Journal of Neurointerventional Surgery
Daniel KaiserJohannes C Gerber

Abstract

To assess whether thrombus surface morphology has an impact on first pass reperfusion in contact aspiration (CA) and stent retriever (SR) thrombectomy. From January 2016 to December 2018, consecutive stroke patients with an occlusion of the middle cerebral artery and thrombectomy (CA or SR) were examined in this retrospective study. We assessed patients' characteristics, procedural data and clinical outcome. Thrombus surface on pretreatment digital subtraction angiography (DSA) was categorized into regular versus irregular phenotype by blinded three-reader-consensus. Primary outcome was successful reperfusion (modified treatment in cerebral ischemia (mTICI) 2b-3) after first pass. Data analysis was stratified according to thrombectomy technique and thrombus phenotype. Among 203 patients (76 years (IQR 65.5-81.9), 47.3% male, National Institutes of Health Stroke Scale Score 16 (IQR 12-20)), 155 patients were treated primarily with CA and 48 with SR. 40% (n=62/155) CA and 41.7% (n=20/48) SR-treated patients had a regular thrombus phenotype. In the CA group, successful reperfusion after first pass was more frequently obtained in patients with regular compared with irregular phenotype (69.4% (n=43/62) vs 34.4% (n=32/93); P<0.0001)....Continue Reading

References

Jun 30, 2015·Lancet Neurology·Bruce C V CampbellStephen M Davis
Jan 4, 2017·Journal of Neurointerventional Surgery·Gillian M GunningPatrick A Brouwer
Jun 20, 2017·Stroke; a Journal of Cerebral Circulation·Peter B SpornsThomas Ulrich Niederstadt
Feb 21, 2018·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatRaul G Nogueira
Jun 21, 2019·Stroke; a Journal of Cerebral Circulation·Omid NikoubashmanMartin Wiesmann
Jun 30, 2019·Journal of Neurointerventional Surgery·Arturo ConsoliUNKNOWN ASTER Trial Investigators

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Citations

Dec 2, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Xiangyuan ZhangJunjie Jiang
Sep 1, 2021·Clinical Neuroradiology·Nebiyat F BelachewPasquale Mordasini

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