Journal article
Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy
Journal of neurointerventional surgery, Vol.18(2), pp.390-398
02/2026
DOI: 10.1136/jnis-2024-022781
PMID: 39884851
Abstract
BackgroundThe contact aspiration (CA) technique is often used to perform endovascular thrombectomy (EVT) for acute ischemic stroke (AIS); however, rescue strategies are necessary if CA fails to achieve recanalization. This study investigates the outcomes of incorporating stent retriever (SR) thrombectomy in the rescue strategy following failed CA.MethodsEVT patients with failed CA attempts were identified from a large multicenter registry and stratified by rescue technique: CA alone or incorporating SR in the rescue strategy. Outcomes included successful recanalization, 90-day functional outcomes (defined by the modified Rankin Scale (mRS) score), symptomatic intracranial hemorrhage (sICH), and 90-day mortality.ResultsAmong 1885 patients with failed CA attempts, conversion to SR was associated with higher recanalization rates (85.2% vs 80.6%; p=0.03), higher rates of second-pass recanalization (31.2% vs 23.4%; p<0.001), and better 90-day outcomes (mRS 0–2: 35.2% vs 29.9%; p=0.04) when compared with repeated CA attempts. Trevo SRs showed higher odds of successful recanalization (adjusted odds ratio (aOR)=1.9; p=0.02), second-pass recanalization (aOR=1.7; p=0.01), and reduced odds of sICH (aOR=0.3; p=0.02). EmboTrap SRs were associated with higher odds of 90-day mortality (aOR=2.6; p=0.004) and sICH (aOR=2.9; p=0.04) and lower odds of recanalization (aOR=0.5; p=0.03).ConclusionsIncorporating SR in the rescue strategy after a failed CA improves recanalization rates and functional outcomes. Trevo SRs demonstrated superior efficacy and safety when incorporated into the rescue strategy.
Details
- Title: Subtitle
- Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy
- Creators
- Mohamad Ezzeldin - University of HoustonDaniele G Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaMishaal Hukamdad - University of Illinois ChicagoPedro Navia - Hospital Universitario La PazRahim Abo Kasem - Medical University of South CarolinaHugo Cuellar - Louisiana State University Health Sciences Center ShreveportRime Ezzeldin - Jordan University of Science and TechnologyIsabel Fragata - Unidade Local de Saúde de São JoséIlko Maier - Neurology, University Medicine Goettingen, Goettingen, GermanyAdam Polifka - University of FloridaAnsaar T Rai - West Virginia UniversityJustin R Mascitelli - The University of Texas Health Science Center at San AntonioPascal Jabbour - Thomas Jefferson UniversityJoshua W Osbun - Washington University in St. LouisJoon-Tae Kim - Chonnam National University HospitalFazeel Siddiqui - West HealthBrian M Howard - Emory UniversityMark Moss - Washington Regional Medical CenterAli Alawieh - Emory UniversityKaustubh Limaye - Indiana University BloomingtonStacey Q Wolfe - Wake Forest UniversityMaxim Mokin - University of South FloridaRobert M Starke - University of MiamiCharles Matouk - Yale UniversityMarios-Nikos Psychogios - University Hospital of BaselMin S Park - University of VirginiaAmir Shaban - University of IowaWaleed Brinjikji - Mayo ClinicNitin Goyal - Semmes Murphey FoundationErgun Daglioglu - Ankara Bilkent City HospitalJustin Dye - Loma Linda UniversityRichard Williamson - Allegheny Health NetworkAli Alaraj - University of Illinois ChicagoDavid J Altschul - Montefiore Medical CenterShinichi Yoshimura - Hyogo Medical UniversityChristopher S Ogilvy - Beth Israel Deaconess Medical CenterDavid Fiorella - Stony Brook UniversityRoberto Javier Crosa - Universidad de MontevideoOmar Tanweer - Baylor College of MedicineMichael R Levitt - University of WashingtonBenjamin Gory - Centre Hospitalier Régional et Universitaire de NancyRamesh Grandhi - University of UtahAlexandra R Paul - Albany Medical Center HospitalPeter Kan - The University of Texas Medical Branch at GalvestonWalter Casagrande - Hospital FernándezShakeel A Chowdhry - NorthShore University HealthSystemMichael F Stiefel - Piedmont HealthCareVarun Chaubal - Lone Star College KingwoodAlejandro M Spiotta - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.18(2), pp.390-398
- DOI
- 10.1136/jnis-2024-022781
- PMID
- 39884851
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Electronic publication date
- 01/30/2025
- Date published
- 02/2026
- Academic Unit
- Neurology
- Record Identifier
- 9984781377602771
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