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Thrombectomy in basilar artery occlusions: impact of number of passes and futile reperfusion.
- Source :
- Journal of NeuroInterventional Surgery; May2023, Vol. 15 Issue 5, p422-427, 131p
- Publication Year :
- 2023
-
Abstract
- Background The number of mechanical thrombectomy (MT) passes is strongly associated with angiographic reperfusion as well as clinical outcomes in patients with anterior circulation ischemic stroke. However, these associations have not been analyzed in patients with basilar artery occlusion (BAO). We investigated the influence of the number of MT passes on the degree of reperfusion and clinical outcomes, and compared outcome after ≤3 passes versus >3 passes. Methods We used data from the prospective multicentric Endovascular Treatment in Ischemic Stroke (ETIS) Registry at 18 sites in France. Patients with BAO treated with MT were included. The primary outcome was a favorable outcome, defined as a modified Rankin Scale score of 0-3 at 90 days. We fit mixed multiple regression models, with center as a random effect. Results We included 275 patients. Successful recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) 2b-3) was achieved in 88.4%, and 41.8% had a favorable outcome. The odds ratio for favorable outcome with each pass above 1 was 0.41 (95% CI 0.23 to 0.73) and for recanalization (mTICI 2b-3) it was 0.70 (95% CI 0.57 to 0.87). In patients with ≤3 passes, the rate of favorable outcome in recanalized versus non-recanalized patients was 50.5% versus 10.0% (p=0.001), while in those with >3 passes it was 16.7% versus 15.2% (p=0.901). Conclusions We found that BAO patients had a significant relationship between the number of MT passes and both recanalization and favorable functional outcome. We further found that the benefit of recanalization in BAO patients was significant only when recanalization was achieved within three passes, encouraging at least three passes before stopping the procedure. [ABSTRACT FROM AUTHOR]
- Subjects :
- ARTERIAL occlusions
RESEARCH
REPORTING of diseases
STROKE
ANTERIOR cerebral artery
CONFIDENCE intervals
MULTIPLE regression analysis
CEREBRAL infarction
ISCHEMIC stroke
THROMBOLYTIC therapy
BASILAR artery
TREATMENT effectiveness
COMPARATIVE studies
THROMBECTOMY
DESCRIPTIVE statistics
REPERFUSION
CEREBRAL ischemia
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 17598478
- Volume :
- 15
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Journal of NeuroInterventional Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 164040800
- Full Text :
- https://doi.org/10.1136/neurintsurg-2022-018715