| Autor: |
Mohammaden, Mahmoud H., Haussen, Diogo C., Perry da Camara, Catarina, Pisani, Leonardo, Gadea, Marta Olive, Al-Bayati, Alhamza R., Liberato, Bernardo, Rangaraju, Srikant, Frankel, Michael R., Nogueira, Raul G. |
| Předmět: |
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| Zdroj: |
Journal of NeuroInterventional Surgery; Jul2021, Vol. 13 Issue 7, p599-604, 6p |
| Abstrakt: |
Background The first-pass effect (FPE) has emerged as a key metric for efficacy in mechanical thrombectomy (MT). The hyperdense vessel sign (HDVS) on non-contrast head CT (NCCT) indicates a higher clot content of red blood cells. Objective To assess whether the HDVS could serve as an imaging biomarker for guiding first-line device selection in MT. Methods A prospective MT database was reviewed for consecutive patients with anterior circulation large vessel occlusion stroke who underwent thrombectomy with stent retriever (SR) or contact aspiration (CA) as first-line therapy between January 2012 and November 2018. Pretreatment NCCT scans were evaluated for the presence of HDVS. The primary outcome was FPE (modified Thrombolysis in Cerebral Infarction score 2c/3). The primary analysis was the interaction between HDVS and thrombectomy modality on FPE. Secondary analyses aimed to evaluate the predictors of FPE. Results A total of 779 patients qualified for the analysis. HDVS and FPE were reported in 473 (60.7%) and 286 (36.7%) patients, respectively. The presence of HDVS significantly modified the effect of thrombectomy modality on FPE (p=0.01), with patients with HDVS having a significantly higher rate of FPE with a SR (41.3% vs 22.2%, p=0.001; adjusted OR 2.11 (95% CI 1.20 to 3.70), p=0.009) and non-HDVS patients having a numerically better response to CA (41.4% vs 33.9%, p=0.28; adjusted OR 0.58 (95% CI 0.311 to 1.084), p=0.088). Age (OR 1.01 (95% CI 1.00 to 1.02), p=0.04) and balloon guide catheter (OR 2.08 (95% CI 1.24 to 3.47), p=0.005) were independent predictors of FPE in the overall population. Conclusion Our data suggest that patients with HDVS may have a better response to SRs than CA for the FPE. Larger confirmatory prospective studies are warranted. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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