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CardioVascular and Interventional Radiology

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11.07.2018 | Clinical Investigation

Impact of Retriever Passes on Efficacy and Safety Outcomes of Acute Ischemic Stroke Treated with Mechanical Thrombectomy

verfasst von: Yongjie Bai, Jie Pu, Huaiming Wang, Dong Yang, Yonggang Hao, Haowen Xu, Meng Zhang, Yu Geng, Yue Wan, Wei Wang, Hao Zhang, Wenjie Zi, Xinfeng Liu, Gelin Xu, for the ACTUAL Investigators

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 12/2018

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Abstract

Background and Purpose

In patients with acute ischemic stroke treated with thrombectomy, additional retriever passes may increase the likelihood of recanalization, but also the risk of intracranial hemorrhage. This multicenter retrospective register study aimed to evaluate the impact of retriever passes on treatment efficacy and safety outcomes in patients treated with mechanical thrombectomy.

Materials and Methods

Patients with ischemic stroke due to large artery occlusion in anterior circulation and treated with mechanical thrombectomy were enrolled. The primary efficacy outcome was a favorable functional outcome defined as modified Rankin Scale score of 0–2 at 90 days. Major safety outcome was symptomatic intracranial hemorrhage (SICH) and mortality. Multivariate logistic regression was used to analyze the impact of retriever passes on efficacy and safety outcomes.

Results

Of the 472 enrolled patients, the likelihood of favorable outcome declined in patients with more than three retriever passes (44.4% in patients with three passes, 26.3% with four passes, 14.8% with five or more passes). Multivariate logistic regression analysis identified three or less passes as an independent predictor for favorable functional outcomes (OR 2.44, 95% CI 1.10–5.45, P = 0.029). More than three passes was associated with an increased risk of SICH (OR 2.24, 95% CI 1.16–4.33, P = 0.016).

Conclusions

More than three retriever passes may increase the rate of recanalization, but not the likelihood of favorable functional outcomes in ischemic stroke patients treated with mechanical thrombectomy. Notably, multiple retriever passes may also increase the risk of intracranial hemorrhage.

Evidence-Based Medicine

Level of Evidence: Level 4, Case Series.

Nur mit Berechtigung zugänglich

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Titel: Impact of Retriever Passes on Efficacy and Safety Outcomes of Acute Ischemic Stroke Treated with Mechanical Thrombectomy
verfasst von: Yongjie Bai
Jie Pu
Huaiming Wang
Dong Yang
Yonggang Hao
Haowen Xu
Meng Zhang
Yu Geng
Yue Wan
Wei Wang
Hao Zhang
Wenjie Zi
Xinfeng Liu
Gelin Xu
for the ACTUAL Investigators
Publikationsdatum: 11.07.2018
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 12/2018
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-018-2022-0

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Impact of Retriever Passes on Efficacy and Safety Outcomes of Acute Ischemic Stroke Treated with Mechanical Thrombectomy