Universität zu Köln

Styczen, Hanna, Huseynov, Elvin, Abdullayev, Nuran, Maus, Volker, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Goertz, Lukas, Onur, Oezguer A., Stockero, Andrea ORCID: 0000-0002-2781-8860, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 and Kabbasch, Christoph (2020). y Adjustment of Stent Retriever Length to Clot Extent Affects First-Pass Reperfusion in Endovascular Treatment of Acute Ischemic Stroke. Cerebrovasc. Dis., 49 (3). S. 277 - 285. BASEL: KARGER. ISSN 1421-9786

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Abstract

Background:Stent retriever technology has evolved, and significantly longer devices have become available for mechanical thrombectomy (MT) of large cerebral vessel occlusions in ischemic stroke. We hypothesized that increased stent retriever length may improve the rate of complete angiographic reperfusion and decrease the respective number of attempts, resulting in a better clinical outcome.Methods:Retrospective analysis of patients with large vessel occlusion in the anterior and posterior circulation treated with stent retriever MT. The study group was dichotomized into short (20 mm) and long (>20 mm) retrievers using propensity matching. In the anterior circulation, the clot burden score was evaluated. Primary end points were first-pass modified thrombolysis in cerebral infarction (mTICI) 3 reperfusion and first-pass mTICI >= 2b reperfusion, and the secondary end point was functional independence (defined as modified Rankin Scale score 0-2) at discharge and 90 days.Results:Overall, 394 patients were included in the analysis. In the anterior circulation, short stent retrievers had a significantly higher rate of first-pass reperfusion in cases with low clot burden (mTICI 3: 27% vs. 17%;p= 0.009; mTICI >= 2b: 42 vs. 30%;p= 0.005) and in middle cerebral artery occlusions (mTICI >= 2b: 51 vs. 41%;p= 0.024). Higher rates of favorable outcome at discharge and 90 days were observed for the short stent retriever group (p< 0.001).Conclusion:Stent retriever length should be adjusted to clot burden score and vessel occlusion site.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Styczen, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Huseynov, Elvin UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Onur, Oezguer A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stockero, Andrea UNSPECIFIED orcid.org/0000-0002-2781-8860 UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-327410
DOI:	10.1159/000508028
Journal or Publication Title:	Cerebrovasc. Dis.
Volume:	49
Number:	3
Page Range:	S. 277 - 285
Date:	2020
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9786
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MECHANICAL THROMBECTOMY; BURDEN SCORE; GUIDELINES; EFFICACY; OUTCOMES; PUSH Multiple languages Clinical Neurology; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32741