CIMFLOVÁ, Petra, Nishita SINGH, Johanna M OSPEL, Martha MARKO, Nima KASHANI, Arnuv MAYANK, Ricardo HANEL, Diogo C HAUSSEN, Aditya BHARATHA, David VOLDERS, Manraj K S HERAN, Alexandre Y POPPE, van Adel BRIAN, Bijoy K MENON, Manish JOSHI, Andrew DEMCHUK, Ryan MCTAGGART, Raul G NOGUEIRA, Jeremy L REMPEL, Charlotte ZERNA, Michael TYMIANSKI, Michael D HILL, Mayank GOYAL and Mohammed A ALMEKHLAFI. Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial. CLINICAL NEURORADIOLOGY. HEIDELBERG: SPRINGER HEIDELBERG, 2022, vol. 32, No 3, p. 799-807. ISSN 1869-1439. Available from: https://dx.doi.org/10.1007/s00062-021-01123-0.
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Basic information
Original name Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial
Authors CIMFLOVÁ, Petra (203 Czech Republic, belonging to the institution), Nishita SINGH, Johanna M OSPEL, Martha MARKO, Nima KASHANI, Arnuv MAYANK, Ricardo HANEL, Diogo C HAUSSEN, Aditya BHARATHA, David VOLDERS, Manraj K S HERAN, Alexandre Y POPPE, van Adel BRIAN, Bijoy K MENON, Manish JOSHI, Andrew DEMCHUK, Ryan MCTAGGART, Raul G NOGUEIRA, Jeremy L REMPEL, Charlotte ZERNA, Michael TYMIANSKI, Michael D HILL, Mayank GOYAL and Mohammed A ALMEKHLAFI (guarantor).
Edition CLINICAL NEURORADIOLOGY, HEIDELBERG, SPRINGER HEIDELBERG, 2022, 1869-1439.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30224 Radiology, nuclear medicine and medical imaging
Country of publisher Germany
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 2.800
RIV identification code RIV/00216224:14110/22:00128452
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1007/s00062-021-01123-0
UT WoS 000739761200001
Keywords in English Ischemic stroke; Endovascular treatment; Bypass effect; Device-thrombus interaction; Thrombus position within the stent-retriever
Tags 14110119, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 31/1/2023 14:34.
Abstract
Background Successful reperfusion determines the treatment effect of endovascular thrombectomy. We evaluated stent-retriever characteristics and their relation to reperfusion in the ESCAPE-NA1 trial. Methods Independent re-scoring of reperfusion grade for each attempt was conducted. The following characteristics were evaluated: stent-retriever length and diameter, thrombus position within stent-retriever, bypass effect, deployment in the superior or inferior MCA trunk, use of balloon guide catheter and distal access catheter. Primary outcome was successful reperfusion defined as expanded thrombolysis in cerebral infarction (eTICI) 2b-3 per attempt. The secondary outcome was successful reperfusion eTICI 2b-3 after the first attempt. Separate regression models for each stent-retriever characteristic and an exploratory multivariable modeling to test the impact of all characteristics on successful reperfusion were built. Results Of 1105 patients in the trial, 809 with the stent-retriever use (1241 attempts) were included in the primary analysis. The stent-retriever was used as the first-line approach in 751 attempts. A successful attempt was associated with thrombus position within the proximal or middle third of the stent (OR 2.06; 95% CI: 1.24-3.40 and OR 1.92; 95% CI: 1.16-3.15 compared to the distal third respectively) and with bypass effect (OR 1.7; 95% CI: 1.07-2.72). Thrombus position within the proximal or middle third (OR 2.80; 95% CI: 1.47-5.35 and OR 2.05; 95% CI: 1.09-3.84, respectively) was associated with first-pass eTICI 2b-3 reperfusion. In the exploratory analysis accounting for all characteristics, bypass effect was the only independent predictor of eTICI 2b-3 reperfusion (OR 1.95; 95% CI: 1.10-3.46). Conclusion The presence of bypass effect and thrombus positioning within the proximal and middle third of the stent-retriever were strongly associated with successful reperfusion.
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