Fast Stent Retrieval during Mechanical Thrombectomy Improves Recanalization in Patients with the Negative Susceptibility Vessel Sign

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FIG 1.
Study flow chart. AIS indicates acute ischemic stroke; MT, mechanical thrombectomy; ACA, anterior cerebral artery; ADAPT, a direct aspiration first pass technique.
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FIG 2.
A, First-pass recanalization rates according to fast and slow retrieval. B, Recanalization rates according to fast and slow retrieval.

Table 1:

Baseline patient characteristics^{^a}

Variables	Fast Retrieval (n = 31)	Slow Retrieval (n = 37)	P Value
Demographics
Age (yr)	77 (57.5–83.7)	65 (49–75.7)	.10
Women	20 (64.5%)	19 (51.4%)	.28
Medical history
Smoking	7 (22.6%)	13 (35.1%)	.26
Hypertension	19 (61.3%)	22 (59.5%)	.88
Diabetes mellitus	7 (22.6%)	8 (21.6%)	.92
Dyslipidemia	12 (38.7%)	12 (32.4%)	.59
Cardiovascular events	9 (29.0%)	11 (29.7%)	.95
Clinical data at presentation
NIHSS	17 (13.25–19.75)	17 (14–20)	.94
Serum glucose level (mmol/L)^{^b}	7.5 (5.9–8.7)	6.8 (5.7–9.5)	.92
Intravenous thrombolysis	16 (51.6%)	26 (70.3%)	.12
Imaging data
DWI-ASPECTS	6 (6–8)	7 (5–8.25)	.47
Left cerebral territory	10 (32.3%)	19 (51.4%)	.12
Occlusion site			.50
ICA-L	4 (12.9%)	5 (13.5%)
M1	24 (77.4%)	25 (67.6%)
M2	3 (9.7%)	7 (18.9%)
Stroke etiology			.76
Large-artery atherosclerosis	4 (12.9%)	7 (18.9%)
Cardioembolism	10 (32.3%)	11 (29.7%)
Other known etiology	3 (9.7%)	2 (5.4%)
Unknown	14 (45.2%)	17 (45.9%)
Angiographic data
Symptom onset to thrombectomy (min)	254.5 (184–295)	230.5 (189.5–310.5)	.90
Good collaterals (ASITN/SIR 3–4)	10 (32.3%)	18 (48.6%)	.37
Balloon-guided catheter	2 (6.5%)	3 (8.1%)	1

Note:—ASITN/SIR indicates American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology.
↵a Continuous variables are described as median and interquartile range, and categoric variables, as number and percentage.
↵b Missing data for 13 and 10 patients, respectively.

Table 2:

Secondary outcomes^{^a}

	Fast Retrieval (n = 31)	Slow Retrieval (n = 37)	P Value
Angiographic outcomes
Distal embolization	4 (12.9%)	9 (24.3%)	.35
Embolization in a new territory	0 (0%)	3 (8.1%)	.24
Procedure-related SAE	2 (6.5%)	1 (2.7%)	.59
Thrombectomy duration (min)	29 (19–75.5)	44 (26.5–71.25)	.16
No. of passes	1 (1–2)	1 (1–3)	.16
One-pass thrombectomy	21 (67.7%)	19 (51.4%)	.22
Imaging outcomes at 24 h^{^b}
Hemorrhagic transformation			.48
None	18 (58.1%)	24 (68.6%)
HI 1	3 (9.7%)	4 (11.4%)
HI 2	6 (19.4%)	3 (8.6%)
PH 1	2 (6.4%)	1 (2.8%)
PH 2	2 (6.4%)	3 (8.6%)
Subarachnoid hemorrhage	2 (6.4%)	3 (8.6%)	1
Symptomatic ICH	2 (6.4%)	2 (5.7%)	1
Perforating artery lesions	1 (3.2%)	1 (2.8%)	.60
Clinical outcome at 90 days
Functional independence	11 (35.5%)	13 (35.1%)	.98
All-cause mortality	6 (19.4%)	8 (21.6%)	.82

Note:—SAE indicates serious adverse event; HI, hemorrhage infarction; PH, parenchymal hematoma; ICH, intracranial hemorrhage.
↵a Continuous variables are described as median and interquartile range, and categoric variables, as counts. Functional independence is defined by an mRS ≤ 2.
↵b Missing data for 2 patients in the slow retrieval group.