Correlation of Thrombectomy Maneuver Count with Recanalization Success and Clinical Outcome in Patients with Ischemic Stroke
Abstract
BACKGROUND AND PURPOSE: In the treatment of acute thromboembolic stroke, the effectiveness and success of thrombus removal when using stent retrievers is variable. In this study, we analyzed the correlation of thrombectomy maneuver count with a good clinical outcome and recanalization success.
MATERIALS AND METHODS: One hundred and four patients with acute occlusion of the middle cerebral artery or the terminal internal carotid artery who were treated with thrombectomy were included in this retrospective study. A good clinical outcome was defined as a 90-day mRS of <2, and successful recanalization was defined as TICI 2b–3.
RESULTS: The maneuver count ranged between 1–10, with a median of 2. Multivariate logistic regression analyses identified an increasing number of thrombectomy maneuvers as an independent predictor of poor outcome (adjusted OR, 0.59; 95% CI, 0.38–0.87; P = .011) and unsuccessful recanalization (adjusted OR, 0.48; 95% CI, 0.32–0.66; P < .001). A good outcome was significantly more likely if finished within 2 maneuvers compared with 3 or 4 maneuvers, or even more than 4 maneuvers (P < .001).
CONCLUSIONS: An increasing maneuver count correlates strongly with a decreasing probability of both good outcome and recanalization. The probability of successful recanalization decreases below 50% if not achieved within 5 thrombectomy maneuvers. Patients who are recanalized within 2 maneuvers have the best chance of achieving a good clinical outcome.
- © 2017 American Society of Neuroradiology
Jump to section
Related Articles
- No related articles found.
Cited By...
- Successful reperfusion in relation to the number of passes: comparing outcomes of first pass expanded Treatment In Cerebral Ischemia (eTICI) 2B with multiple-pass eTICI 3
- Association of asymptomatic hemorrhage after endovascular stroke treatment with outcomes
- Biomarkers of Technical Success After Embolectomy for Acute Stroke
- Impact of Repeated Clot Retrieval Attempts on Infarct Growth and Outcome After Ischemic Stroke
- Systematic review and meta-analysis of current rates of first pass effect by thrombectomy technique and associations with clinical outcomes
- Beyond the first pass: revascularization remains critical in stroke thrombectomy
- Comparing different thrombectomy techniques in five large-volume centers: a 'real world observational study
This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.
- Romain Bourcier, Mayank Goyal, David S. Liebeskind, Keith W. Muir, Hubert Desal, Adnan H. Siddiqui, Diederik W. J. Dippel, Charles B. Majoie, Wim H. van Zwam, Tudor G. Jovin, Elad I. Levy, Peter J. Mitchell, Olvert A. Berkhemer, Stephen M. Davis, Imad Derraz, Geoffrey A. Donnan, Andrew M. Demchuk, Robert J. van Oostenbrugge, Michael Kelly, Yvo B. Roos, Reza Jahan, Aad van der Lugt, Marieke Sprengers, Stephane Velasco, Geert J. Lycklama à Nijeholt, Wagih Ben Hassen, Paul Burns, Scott Brown, Emmanuel Chabert, Timo Krings, Hana Choe, Christian Weimar, Bruce C. V. Campbell, Gary A. Ford, Marc Ribo, Phil White, Geoffrey C. Cloud, Luis San Roman, Antoni Davalos, Olivier Naggara, Michael D. Hill, Serge BracardJAMA Neurology 2019 76 4
- Álvaro García-Tornel, Manuel Requena, Marta Rubiera, Marian Muchada, Jorge Pagola, David Rodriguez-Luna, Matias Deck, Jesus Juega, Noelia Rodríguez-Villatoro, Sandra Boned, Marta Olivé-Gadea, Alejandro Tomasello, David Hernández, Carlos A. Molina, Marc RiboStroke 2019 50 7
- Fabian Flottmann, Hannes Leischner, Gabriel Broocks, Jawed Nawabi, Martina Bernhardt, Tobias Djamsched Faizy, Milani Deb-Chatterji, Götz Thomalla, Jens Fiehler, Caspar BrekenfeldStroke 2018 49 10
- Ulf Neuberger, Philipp Kickingereder, Silvia Schönenberger, Simon Schieber, Peter A. Ringleb, Martin Bendszus, Johannes Pfaff, Markus A. MöhlenbruchNeuroradiology 2019 61 4
- Fabian Flottmann, Caspar Brekenfeld, Gabriel Broocks, Hannes Leischner, Rosalie McDonough, Tobias D. Faizy, Milani Deb-Chatterji, Anna Alegiani, Götz Thomalla, Anastasios Mpotsaris, Christian H. Nolte, Jens Fiehler, Máté E. Maros, Tobias Boeckh-Behrens, Silke Wunderlich, Martin Wiesmann, Ulrike Ernemann, Till-Karsten Hauser, Eberhard Siebert, Sarah Zweynert, Georg Bohner, Alexander Ludolph, Karl-Heinz Henn, Waltraud Pfeilschifter, Marlis Wagner, Joachim Röther, Bernd Eckert, Jörg Berrouschot, Albrecht Bormann, Christian Gerloff, Elke Hattingen, Gabor Petzold, Sven Thonke, Christopher Bangard, Christoffer Kraemer, Martin Dichgans, Frank Wollenwebe, Lars Kellert, Franziska Dorn, Moriz Herzberg, Marios Psychogios, Jan Liman, Martina Petersen, Florian Stögbauer, Peter Kraft, Mirko Pham, Michael Braun, Gerhard F. Hamann, Andreas Kastrup, Christian Roth, Klaus Gröschel, Timo Uphaus, Volker LimmrothStroke 2021 52 2
- Mehdi Abbasi, Yang Liu, Seán Fitzgerald, Oana Madalina Mereuta, Jorge L Arturo Larco, Asim Rizvi, Ramanathan Kadirvel, Luis Savastano, Waleed Brinjikji, David F KallmesJournal of NeuroInterventional Surgery 2021 13 3
- Gaurav Jindal, Helio De Paula Carvalho, Aaron Wessell, Elizabeth Le, Varun Naragum, Timothy Ryan Miller, Marcella Wozniak, Ravi Shivashankar, Carolyn A Cronin, Chad Schrier, Dheeraj GandhiJournal of NeuroInterventional Surgery 2019 11 11
- Amélie Carolina Hesse, Daniel Behme, André Kemmling, Antonia Zapf, Nils Große Hokamp, Isabelle Frischmuth, Ilko Maier, Jan Liman, Ioannis Tsogkas, Jan-Hendrik Buhk, Julia Tran, Jens Fiehler, Anastasios Mpotsaris, Peter Schramm, Ansgar Berlis, Michael Knauth, Marios-Nikos PsychogiosJournal of NeuroInterventional Surgery 2018 10 6
- Senna Staessens, Olivier François, Waleed Brinjikji, Karen M. Doyle, Peter Vanacker, Tommy Andersson, Simon F. De MeyerStroke 2021 52 11
- Charlotte S. Weyland, Yahia Mokli, Johannes A. Vey, Meinhard Kieser, Christian Herweh, Silvia Schönenberger, Martin Bendszus, Markus A. Möhlenbruch, Peter A. Ringleb, Simon NagelStroke 2021 52 4