Multicenter investigation of technical and clinical outcomes after thrombectomy for Proximal Medium Vessel Occlusion (pMeVO) by frontline technique

Autor: Jonathan A Grossberg, Reda M Chalhoub, Sami Al Kasab, Dominika Pullmann, Pascal Jabbour, Marios Psychogios, Robert M Starke, Adam S Arthur, Kyle M Fargen, Reade De Leacy, Peter Kan, Travis Dumont, Ansaar Rai, Roberto J Crosa, Kareem E Naamani, Ilko Maier, Nitin Goyal, Stacey Quintero Wolfe, C Michael Cawley, J Mocco, Muhammad Hafeez, Brian M Howard, Laurie Dimisko, Hassan Saad, Christopher S Ogilvy, R Webster Crowley, Justin Mascitelli, Isabel Fragata, Michael Levitt, Alejandro M Spiotta, Ali M Alawieh
Rok vydání: 2022
Předmět:
Zdroj: Interventional Neuroradiology. :159101992211381
ISSN: 2385-2011
1591-0199
DOI: 10.1177/15910199221138139
Popis: Background Endovascular thrombectomy(EVT) is the standard of care for large vessel occlusion(LVO) stroke. Data on technical and clinical outcome in proximal medium vessel occlusions(pMeVOs) comparing frontline techniques remain limited. Methods We report an international multicenter retrospective study of patients undergoing EVT for stroke at 32 centers between 2015–2021. Patients were divided into LVOs(ICA/M1/Vertebrobasilar) or pMeVOs(M2/A1/P1) and categorized by thrombectomy technique. Primary outcome was 90-day good functional outcome(mRS ≤ 2). Multivariate logistic regressions were used to evaluate the impact of technical variables on clinical outcomes. Propensity score matching was used to compare outcome in patients with pMeVO treated with aspiration versus stent-retriever. Results In the cohort of 5977 LVO and 1287 pMeVO patients, pMeVO did not independently predict good-outcome(p = 0.55). In pMeVO patients, successful recanalization irrespective of frontline technique(aOR = 3.2,p Conclusions Clinical outcomes following EVT for pMeVO are comparable to those in LVOs. The golden hour or 3-pass rules in LVO thrombectomy still apply to pMeVO thrombectomy. Different techniques may exhibit different futility metrics; SR thrombectomy was more influenced by attempts whereas aspiration was more dependent on procedure time.
Databáze: OpenAIRE
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