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

医学 倾向得分匹配 冲程(发动机) 回顾性队列研究 闭塞 支架 队列 逻辑回归 外科 第一次通过 内科学 数学 机械工程 算术 工程类
作者
Jonathan A Grossberg,Reda 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 M. Dumont,Ansaar Rai,Roberto Crosa,Kareem El Naamani,Ilko Maier,Nitin Goyal,Stacey Q Wolfe,C. Michael Cawley,J Mocco,Muhammad Ubaid Hafeez,Brian M. Howard,Laurie Dimisko,Hassan Saad,Christopher S. Ogilvy,R. Webster Crowley,Justin Mascitelli,Isabel Fragata,Michael R. Levitt,Alejandro M Spiotta,Ali Alawieh
出处
期刊:Interventional Neuroradiology [SAGE Publishing]
卷期号:: 159101992211381-159101992211381 被引量:6
标识
DOI:10.1177/15910199221138139
摘要

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 < 0.05), procedure time ≤ 1-h(aOR = 2.2,p < 0.05), and thrombectomy attempts ≤ 4(aOR = 2.8,p < 0.05) were independent predictors of good-outcomes. In a propensity-matched cohort of aspiration versus stent-retriever pMeVO patients, there was no difference in good-outcomes. The rates of hemorrhage were higher(9%vs.4%,p < 0.01) and procedure time longer(51-min vs. 33-min,p < 0.01) with stent-retriever, while the number of attempts was higher with aspiration(2.5vs.2,p < 0.01). Rates of hemorrhage and good-outcome showed an exponential relationship to procedural metrics, and were more dependent on time in the aspiration group compared to attempts in the stent-retriever group. 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.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
复杂的白秋完成签到,获得积分10
刚刚
刚刚
舒适的平蓝完成签到,获得积分10
1秒前
DAI123完成签到,获得积分10
1秒前
1秒前
阳yang发布了新的文献求助10
1秒前
HIH完成签到 ,获得积分10
2秒前
可靠的寒风完成签到,获得积分10
3秒前
Pan完成签到,获得积分10
3秒前
4秒前
4秒前
4秒前
丢丢丢完成签到,获得积分10
4秒前
安静的ky完成签到,获得积分10
4秒前
JamesPei应助mary采纳,获得10
4秒前
木子林夕完成签到,获得积分10
4秒前
勤奋尔丝完成签到 ,获得积分10
5秒前
5秒前
6秒前
haozi完成签到,获得积分10
6秒前
啾啾啾发布了新的文献求助30
7秒前
KK发布了新的文献求助10
7秒前
魏魏魏完成签到,获得积分10
7秒前
明明发布了新的文献求助10
8秒前
pluto应助淘气科研采纳,获得10
8秒前
晴栀发布了新的文献求助10
8秒前
单纯血茗发布了新的文献求助50
8秒前
冷艳的冬萱完成签到 ,获得积分10
9秒前
lemon完成签到,获得积分10
9秒前
平常的路人完成签到,获得积分10
9秒前
丢丢丢发布了新的文献求助10
10秒前
orixero应助靖123456采纳,获得10
13秒前
SYLH应助chlgkmoney采纳,获得30
13秒前
阳洋洋发布了新的文献求助10
15秒前
所所应助tuo zhang采纳,获得10
16秒前
大米哈哈完成签到,获得积分10
16秒前
16秒前
huoguo完成签到,获得积分10
16秒前
丰富的听云完成签到,获得积分10
16秒前
简单的易云完成签到,获得积分10
18秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038426
求助须知:如何正确求助?哪些是违规求助? 3576119
关于积分的说明 11374556
捐赠科研通 3305834
什么是DOI,文献DOI怎么找? 1819339
邀请新用户注册赠送积分活动 892678
科研通“疑难数据库(出版商)”最低求助积分说明 815029