Journal article
Mechanical thrombectomy for the treatment of primary and secondary anterior cerebral artery occlusions: insights from STAR
Journal of neurointerventional surgery, Vol.16(12), pp.1282-1287
12/2024
DOI: 10.1136/jnis-2023-020997
Abstract
BACKGROUND The safety and efficacy of mechanical thrombectomy (MT) for the treatment of acute anterior cerebral artery (ACA) occlusions have not clearly been delineated. Outcomes may be impacted based on whether the occlusion is isolated to the ACA (primary ACA occlusion) or occurs in conjunction with other cerebral arteries (secondary).METHODS We performed a retrospective review of the multicenter Stroke Thrombectomy and Aneurysm (STAR) database. All patients with MT-treated primary or secondary ACA occlusions were included. Baseline characteristics, procedural outcomes, complications, and clinical outcomes were collected. Primary and secondary ACA occlusions were compared using the Mann-Whitney U test and Kruskal-Willis test for continuous variables and the χ2 test for categorical variables. RESULTS The study cohort comprised 238 patients with ACA occlusions (49.2% female, median (SD) age 65.6 (16.7) years). The overall rate of successful recanalization was 75%, 90-day good functional outcome was 23%, and 90-day mortality was 35%. There were 44 patients with a primary ACA occlusion and 194 patients with a secondary ACA occlusion. When adjusted for baseline variables, the rates of successful recanalization (68% vs 76%, P=0.27), 90-day good functional outcome (41% vs 19%, P=0.38), and mortality at 90 days (25% vs 38%, P=0.12) did not differ between primary and secondary ACA occlusion groups. CONCLUSION Clinical and procedural outcomes are similar between MT-treated primary and secondary ACA occlusions for select patients. Our findings demonstrate the need for established criteria to determine ideal patient and ACA stroke characteristics amenable to MT treatment.
Details
- Title: Subtitle
- Mechanical thrombectomy for the treatment of primary and secondary anterior cerebral artery occlusions: insights from STAR
- Creators
- Nisha Dabhi - University of VirginiaJeyan Sathia Kumar - University of VirginiaNatasha Ironside - University of VirginiaRyan T Kellogg - University of VirginiaMohammad-Mahdi Sowlat - Medical University of South CarolinaKazutaka Uchida - Hyogo Medical UniversityIlko MaierSami Al Kasab - Medical University of South CarolinaPascal Jabbour - Thomas Jefferson UniversityJoon-Tae KimStacey Q Wolfe - Wake Forest UniversityAnsaar Rai - West Virginia University HospitalsRobert M Starke - University of MiamiMarios-Nikos PsychogiosEdgar A Samaniego - University of IowaAdam S Arthur - University of Tennessee Health Science CenterShinichi Yoshimura - Hyogo Medical UniversityHugo Cuellar - Louisiana State University Health Sciences Center New OrleansBrian M Howard - Emory UniversityAli Alawieh - Emory UniversityDaniele G Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaOmar Tanweer - NYU Langone HealthJustin Mascitelli - The University of Texas at San Antonio Health Science CenterIsabel Fragata - Unidade Local de Saúde de São JoséAdam J Polifka - University of FloridaJoshua W Osbun - Washington University in St. LouisRoberto Javier CrosaCharles Matouk - Yale UniversityMichael R Levitt - University of WashingtonWaleed Brinjikji - Mayo Clinic in ArizonaMark Moss - Washington Regional Medical CenterTravis M Dumont - University of ArizonaRichard Williamson - Allegheny Health NetworkPedro Navia - Hospital Universitario La PazPeter Kan - The University of Texas Medical Branch at GalvestonReade De Leacy - Icahn School of Medicine at Mount SinaiShakeel A Chowdhry - Endeavor HealthMohamad Ezzeldin - University of HoustonAlejandro M Spiotta - Medical University of South CarolinaMin S Park - University Hospital of Basel
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.16(12), pp.1282-1287
- DOI
- 10.1136/jnis-2023-020997
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Grant note
- DOI: 10.13039/100016303, name: Medtronic Foundation, award: N/A; DOI: 10.13039/100008894, name: Stryker, award: N/A; DOI: 10.13039/100020501, name: Penumbra, award: N/A
- Language
- English
- Electronic publication date
- 11/15/2023
- Date published
- 12/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984513362702771
Metrics
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