Association of Stent-Retriever Characteristics in Establishing
Successful Reperfusion During Mechanical Thrombectomy Results
from the ESCAPE-NA1 Trial

J 2022

Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial

CIMFLOVÁ, Petra, Nishita SINGH, Johanna M OSPEL, Martha MARKO, Nima KASHANI et. al.

Základní údaje

Originální název

Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial

Autoři

CIMFLOVÁ, Petra (203 Česká republika, domácí), 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 a Mohammed A ALMEKHLAFI (garant)

Vydání

CLINICAL NEURORADIOLOGY, HEIDELBERG, SPRINGER HEIDELBERG, 2022, 1869-1439

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30224 Radiology, nuclear medicine and medical imaging

Stát vydavatele

Německo

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.800

Kód RIV

RIV/00216224:14110/22:00128452

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1007/s00062-021-01123-0

UT WoS

000739761200001

Klíčová slova anglicky

Ischemic stroke; Endovascular treatment; Bypass effect; Device-thrombus interaction; Thrombus position within the stent-retriever

Štítky

14110119, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 31. 1. 2023 14:34, Mgr. Tereza Miškechová

Anotace

V originále

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.

Citovat

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 a 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, roč. 32, č. 3, s. 799-807. ISSN 1869-1439. Dostupné z: https://dx.doi.org/10.1007/s00062-021-01123-0.

@article{2251514,
   author = {Cimflová, Petra and Singh, Nishita and Ospel, Johanna M and Marko, Martha and Kashani, Nima and Mayank, Arnuv and Hanel, Ricardo and Haussen, Diogo C and Bharatha, Aditya and Volders, David and Heran, Manraj K S and Poppe, Alexandre Y and Brian, van Adel and Menon, Bijoy K and Joshi, Manish and Demchuk, Andrew and McTaggart, Ryan and Nogueira, Raul G and Rempel, Jeremy L and Zerna, Charlotte and Tymianski, Michael and Hill, Michael D and Goyal, Mayank and Almekhlafi, Mohammed A},
   article_location = {HEIDELBERG},
   article_number = {3},
   doi = {http://dx.doi.org/10.1007/s00062-021-01123-0},
   keywords = {Ischemic stroke; Endovascular treatment; Bypass effect; Device-thrombus interaction; Thrombus position within the stent-retriever},
   language = {eng},
   issn = {1869-1439},
   journal = {CLINICAL NEURORADIOLOGY},
   title = {Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial},
   url = {https://link.springer.com/article/10.1007/s00062-021-01123-0},
   volume = {32},
   year = {2022}
}

TY  - JOUR
ID  - 2251514
AU  - Cimflová, Petra - Singh, Nishita - Ospel, Johanna M - Marko, Martha - Kashani, Nima - Mayank, Arnuv - Hanel, Ricardo - Haussen, Diogo C - Bharatha, Aditya - Volders, David - Heran, Manraj K S - Poppe, Alexandre Y - Brian, van Adel - Menon, Bijoy K - Joshi, Manish - Demchuk, Andrew - McTaggart, Ryan - Nogueira, Raul G - Rempel, Jeremy L - Zerna, Charlotte - Tymianski, Michael - Hill, Michael D - Goyal, Mayank - Almekhlafi, Mohammed A
PY  - 2022
TI  - Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial
JF  - CLINICAL NEURORADIOLOGY
VL  - 32
IS  - 3
SP  - 799-807
EP  - 799-807
PB  - SPRINGER HEIDELBERG
SN  - 18691439
KW  - Ischemic stroke
KW  - Endovascular treatment
KW  - Bypass effect
KW  - Device-thrombus interaction
KW  - Thrombus position within the stent-retriever
UR  - https://link.springer.com/article/10.1007/s00062-021-01123-0
N2  - 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.
ER  -

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 a Mohammed A ALMEKHLAFI. Association of Stent-Retriever Characteristics in Establishing Successful Reperfusion During Mechanical Thrombectomy Results from the ESCAPE-NA1 Trial. \textit{CLINICAL NEURORADIOLOGY}. HEIDELBERG: SPRINGER HEIDELBERG, 2022, roč.~32, č.~3, s.~799-807. ISSN~1869-1439. Dostupné z: https://dx.doi.org/10.1007/s00062-021-01123-0.

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