151. Number of Stent Retriever Passes Associated With Futile Recanalization in Acute Stroke
- Author
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Hyo Sung Kwak, Jin Woo Kim, Oh Young Bang, Joonsang Yoo, Sang Il Suh, Seung Kug Baik, Dong Joon Kim, Hong Gee Roh, Byungjun Kim, Jun Soo Byun, Pyoung Jeon, Hong Jun Jeon, Sang Heum Kim, Jeong Jin Park, Hyungjong Park, Chang-Woo Ryu, Jang Hyun Baek, Woong Jae Lee, Byoung Soo Shin, Hyo Suk Nam, Ji Hoe Heo, Yon Kwon Ihn, Kyung-Yul Lee, Sang Hyun Suh, Young Jun Lee, Jieun Roh, Byung Moon Kim, and Young Dae Kim
- Subjects
Male ,medicine.medical_specialty ,Computed Tomography Angiography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,In patient ,Treatment Failure ,Favorable outcome ,Stroke ,Aged ,Retrospective Studies ,Thrombectomy ,Stent retriever ,Acute stroke ,Aged, 80 and over ,Advanced and Specialized Nursing ,business.industry ,Endovascular Procedures ,Large artery occlusion ,Infarction, Middle Cerebral Artery ,Middle Aged ,Prognosis ,medicine.disease ,Multivariate Analysis ,Cardiology ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background and Purpose— Stent retriever (SR) thrombectomy has become the mainstay of treatment of acute intracranial large artery occlusion. However, it is still not much known about the optimal limit of SR attempts for favorable outcome. We evaluated whether a specific number of SR passes for futile recanalization can be determined. Methods— Patients who were treated with a SR as the first endovascular modality for their intracranial large artery occlusion in anterior circulation were retrospectively reviewed. The recanalization rate for each SR pass was calculated. The association between the number of SR passes and a patient’s functional outcome was analyzed. Results— A total of 467 patients were included. Successful recanalization by SR alone was achieved in 82.2% of patients. Recanalization rates got sequentially lower as the number of passes increased, and the recanalization rate achievable by ≥5 passes of the SR was 5.5%. In a multivariable analysis, functional outcomes were more favorable in patients with 1 to 4 passes of the SR than in patients without recanalization (odds ratio [OR] was 8.06 for 1 pass; OR 7.78 for 2 passes; OR 6.10 for 3 passes; OR 6.57 for 4 passes; all P P =0.455; OR 0.33 with 0.02–5.70, P =0.445 for ≥6 passes). Conclusions— The likelihood of successful recanalization got sequentially lower as the number of SR passes increased. Five or more passes of the SR became futile in terms of the recanalization rate and functional outcomes.
- Published
- 2018
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