Abstract
Abstract WP192: Impact of Second Line Thrombectomy Technique Following Failed First Pass Thrombectomy for Anterior Circulation Stroke: To Switch or Not to Switch?
Stroke (1970), Vol.55(Suppl_1)
02/2024
DOI: 10.1161/str.55.suppl_1.WP192
Abstract
Abstract only Introduction: Despite comparable outcomes for different frontline techniques in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), there are sparse data regarding if and when to switch techniques if the first pass is unsuccessful. We aimed to investigate the impact of converting from one MT technique to another on the second MT attempt for AIS among patients with large vessel occlusion (LVO). Methods: This was a retrospective observational study using data from the large multicenter international Stroke Thrombectomy and Aneurysm Registry (STAR). Data from 29 stroke centers for 10,229 AIS patients treated with MT for LVO between January 2010 and December 2022 was investigated. The primary outcome measure was successful recanalization defined as modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2b or higher. 90-day modified Rankin score (mRS) 0-2, mortality and symptomatic hemorrhage were used as secondary outcomes. Clinical and technical outcomes after the second MT attempt were compared between those with or without technique conversion. Results: Among 10,229 AIS patients, 1,797 AIS patients with LVO failed first pass recanalization and were included in this retrospective analysis. 927 patients were female (52%) and median (interquartile range) age was 72 (61-81) years. Converting to alternative techniques following a first failed attempt was more likely to be associated with successful recanalization at the second attempt (adjusted odds ratio 2.30, 95% CI: 1.37-3.86, P = 0.002) and 90-day good clinical outcome (adjusted odds ratio 2.10, 95% CI: 1.15-3.85, P = 0.02) after multivariate adjustment. Conclusions: This study demonstrates better clinical and technical outcomes with conversion of MT technique for the second attempt in AIS patients with LVO who failed first pass recanalization.
Details
- Title: Subtitle
- Abstract WP192: Impact of Second Line Thrombectomy Technique Following Failed First Pass Thrombectomy for Anterior Circulation Stroke: To Switch or Not to Switch?
- Creators
- Hidetoshi Matsukawa - Medical University of South CarolinaKazutaka Uchida - Hyogo UniversityAli Alawieh - Emory UniversityCharles Matouk - Yale UniversitySami Al Kasab - Medical University of South CarolinaMohammad-Mahdi Sowlat - University of South CarolinaSameh S Elawady - Medical University of South CarolinaIlko Maier - Universitätsmedizin GöttingenPascal Jabbour - Thomas Jefferson UniversityJoon-Tae Kim - Chonnam National UniversityStacey Q Wolfe - Wake Forest UniversityAnsaar Rai - West Virginia UniversityRobert M Starke - University of Miami Health SystemMarios-Nikos Psychogios - University Hospital of BaselEdgar Samaniego - University of IowaAdam Arthur - University of Tennessee Health Science CenterHugo Cuellar - Louisiana State University in ShreveportBrian Howard - Emory UniversityDaniele G. Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaOmar Tanweer - Baylor College of MedicineJustin Mascitelli - The University of Texas Health Science Center at San AntonioIsabel Fragata - Hospital de São JoséAdam Polifka - University of FloridaJoshua Osbun - Washington University in St. LouisRoberto Crosa - Neurosurgery, Endovascular Neurological Cntr, Montevideo, UruguayMin S Park - University of VirginiaMichael Levitt - University of WashingtonWaleed Brinjikji - Mayo Clinic in ArizonaMark Moss - Washington Regional Medical CenterTravis Dumont - University of ArizonaRichard Williamson - Allegheny Health NetworkPedro Navia - Hospital Universitario La PazPeter Kan - The University of Texas Medical Branch at GalvestonReade De Leacy - Mount Saint Vincent UniversityShakeel Chowdhry - NorthShore University HealthSystemMohamad Ezzeldin - Lone Star College KingwoodShinichi Yoshimura - Hyogo UniversityAlejandro M Spiotta - Medical University of South Carolina
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.55(Suppl_1)
- DOI
- 10.1161/str.55.suppl_1.WP192
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2024
- Academic Unit
- Neurosurgery; Radiology; Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984557842602771
Metrics
4 Record Views