E-045 Second line thrombectomy technique following an unsuccessful first pass thrombectomy for anterior circulation large vessel occlusion stroke: to switch or not to switch?

B Howard; D Romano; H Matsukawa; O Tanweer; J Mascitelli; K Uchida; A Alawieh; I Fragata; C Matouk; J Osbun; S Al Kasab; R Crosa; M Sowlat; M S Park; S Elawady; M R Levitt; R Abo Kasem; W Brinjikji; J Isidor; M Moss; I Maier; T Dumont; P Jabbour; R Williamson; P Navia; J Kim; S Quintero Wolfe; P Kan; R De Leacy; A Rai; R M Starke; S Chowdhry; M Psychogios; M Ezzeldin; E Samaniego; S Yoshimura; H Cuellar; A Spiotta

doi:10.1136/jnis-2024-SNIS.150

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E-045 Second line thrombectomy technique following an unsuccessful first pass thrombectomy for anterior circulation large vessel occlusion stroke: to switch or not to switch?

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E-045 Second line thrombectomy technique following an unsuccessful first pass thrombectomy for anterior circulation large vessel occlusion stroke: to switch or not to switch?

B Howard, D Romano, H Matsukawa, O Tanweer, J Mascitelli, K Uchida, A Alawieh, I Fragata, C Matouk, J Osbun, …

Journal of neurointerventional surgery, Vol.16(Suppl 1), pp.A107-A108

07/21/2024

DOI: 10.1136/jnis-2024-SNIS.150

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Abstract

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 MT is unsuccessful. We investigated the converting from one MT technique to another on the second MT attempt for AIS among patients with anterior circulation large vessel occlusion (LVO). Methods This was a retrospective observational study using data from the large multicenter international ‘anonymous’. Data from 29 stroke centers for 10,229 patients between January 2010 and December 2022 was investigated. The primary outcome measure was successful recanalization defined as a modified Thrombolysis in Cerebral Ischemia score ≥2b. 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.Results1,797 patients with unsuccessful first-pass MT were included in this analysis. Converting to alternative techniques following an unsuccessful first-pass MT 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 the conversion of the MT technique for the second attempt in AIS patients with anterior circulation LVO and an unsuccessful first-pass MT.

SNIS 21st annual meeting electronic poster abstracts

Details

Title: Subtitle: E-045 Second line thrombectomy technique following an unsuccessful first pass thrombectomy for anterior circulation large vessel occlusion stroke: to switch or not to switch?
Creators: B Howard - Emory University
D Romano - Neurosurgery, Aou S. Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
H Matsukawa - Medical University of South Carolina
O Tanweer - Baylor College of Medicine
J Mascitelli - The University of Texas Health Science Center at San Antonio
K Uchida - Hyogo University
A Alawieh - Emory University
I Fragata - Universidade Nova de Lisboa
C Matouk - University of New Haven
J Osbun - Washington University in St. Louis
S Al Kasab - Medical University of South Carolina
R Crosa - Universidad de Montevideo
M Sowlat - Medical University of South Carolina
M S Park - Neurosurgery, 1827 University Avenue, Charlottesville, Virginia 22903, Charlottesville, VA
S Elawady - Medical University of South Carolina
M R Levitt - University of Washington
R Abo Kasem - Medical University of South Carolina
W Brinjikji - Mayo Clinic
J Isidor - Medical University of South Carolina
M Moss - Washington Regional Medical Center
I Maier - Universitätsmedizin Göttingen
T Dumont - University of Arizona
P Jabbour - Thomas Jefferson University
R Williamson - Allegheny General Hospital
P Navia - Hospital Universitario La Paz
J Kim - Chonnam National University Hospital
S Quintero Wolfe - Central Baptist Hospital
P Kan - The University of Texas Medical Branch at Galveston
R De Leacy - Mount Sinai Health System
A Rai - West Virginia University
R M Starke - University of Miami Health System
S Chowdhry - NorthShore University HealthSystem
M Psychogios - University Hospital of Basel
M Ezzeldin - University of Houston
E Samaniego - University of Iowa
S Yoshimura - Hyogo Medical University
H Cuellar - Louisiana State University Health Sciences Center Shreveport
A Spiotta - Medical University of South Carolina
Resource Type: Abstract
Publication Details: Journal of neurointerventional surgery, Vol.16(Suppl 1), pp.A107-A108
DOI: 10.1136/jnis-2024-SNIS.150
ISSN: 1759-8478
eISSN: 1759-8486
Publisher: BMJ Publishing Group Ltd
Language: English
Date published: 07/21/2024
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984687780102771

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