• Something wrong with this record ?

First pass effect in patients with large vessel occlusion strokes undergoing neurothrombectomy: insights from the Trevo Retriever Registry

AP. Jadhav, SM. Desai, RF. Budzik, R. Gupta, B. Baxter, JD. English, BM. Bartolini, A. Krajina, DC. Haussen, RG. Nogueira, D. Liebeskind, E. Veznedaroglu

. 2021 ; 13 (7) : 619-622. [pub] 20210121

Language English Country Great Britain

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc21025468

BACKGROUND: First pass effect (FPE), defined as near-total/total reperfusion of the territory (modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3) of the occluded artery after a single thrombectomy attempt (single pass), has been associated with superior safety and efficacy outcomes than in patients not experiencing FPE. OBJECTIVE: To characterize the clinical features, incidence, and predictors of FPE in the anterior and posterior circulation among patients enrolled in the Trevo Registry. METHODS: Data were analyzed from the Trevo Retriever Registry. Univariate and multivariable analyses were used to assess the relationship of patient (demographics, clinical, occlusion location, collateral grade, Alberta Stroke Program Early CT Score (ASPECTS)) and device/technique characteristics with FPE (mTICI 2c/3 after single pass). RESULTS: FPE was achieved in 27.8% (378/1358) of patients undergoing anterior large vessel occlusion (LVO) thrombectomy. Multivariable regression analysis identified American Society of Interventional and Therapeutic Neuroradiology (ASITN) levels 2-4, higher ASPECTS, and presence of atrial fibrillation as independent predictors of FPE in anterior LVO thrombectomy. Rates of modified Rankin Scale (mRS) score 0-2 at 90 days were higher (63.9% vs 53.5%, p<0.0006), and 90-day mortality (11.4% vs 12.8%, p=0.49) was comparable in the FPE group and non-FPE group. Rate of FPE was 23.8% (19/80) among basilar artery occlusion strokes, and outcomes were similar between FPE and non-FPE groups (mRS score 0-2, 47.4% vs 52.5%, p=0.70; mortality 26.3% vs 18.0%, p=0.43). Notably, there were no difference in outcomes in FPE versus non-FPE mTICI 2c/3 patients. CONCLUSION: Twenty-eight percent of patients undergoing anterior LVO thrombectomy and 24% of patients undergoing basilar artery occlusion thrombectomy experience FPE. Independent predictors of FPE in anterior circulation LVO thrombectomy include higher ASITN levels, higher ASPECTS, and the presence of atrial fibrillation.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc21025468
003      
CZ-PrNML
005      
20211026133758.0
007      
ta
008      
211013s2021 xxk f 000 0|eng||
009      
AR
024    7_
$a 10.1136/neurintsurg-2020-016952 $2 doi
035    __
$a (PubMed)33479032
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxk
100    1_
$a Jadhav, Ashutosh P $u Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA jadhav.library@gmail.com $u Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
245    10
$a First pass effect in patients with large vessel occlusion strokes undergoing neurothrombectomy: insights from the Trevo Retriever Registry / $c AP. Jadhav, SM. Desai, RF. Budzik, R. Gupta, B. Baxter, JD. English, BM. Bartolini, A. Krajina, DC. Haussen, RG. Nogueira, D. Liebeskind, E. Veznedaroglu
520    9_
$a BACKGROUND: First pass effect (FPE), defined as near-total/total reperfusion of the territory (modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3) of the occluded artery after a single thrombectomy attempt (single pass), has been associated with superior safety and efficacy outcomes than in patients not experiencing FPE. OBJECTIVE: To characterize the clinical features, incidence, and predictors of FPE in the anterior and posterior circulation among patients enrolled in the Trevo Registry. METHODS: Data were analyzed from the Trevo Retriever Registry. Univariate and multivariable analyses were used to assess the relationship of patient (demographics, clinical, occlusion location, collateral grade, Alberta Stroke Program Early CT Score (ASPECTS)) and device/technique characteristics with FPE (mTICI 2c/3 after single pass). RESULTS: FPE was achieved in 27.8% (378/1358) of patients undergoing anterior large vessel occlusion (LVO) thrombectomy. Multivariable regression analysis identified American Society of Interventional and Therapeutic Neuroradiology (ASITN) levels 2-4, higher ASPECTS, and presence of atrial fibrillation as independent predictors of FPE in anterior LVO thrombectomy. Rates of modified Rankin Scale (mRS) score 0-2 at 90 days were higher (63.9% vs 53.5%, p<0.0006), and 90-day mortality (11.4% vs 12.8%, p=0.49) was comparable in the FPE group and non-FPE group. Rate of FPE was 23.8% (19/80) among basilar artery occlusion strokes, and outcomes were similar between FPE and non-FPE groups (mRS score 0-2, 47.4% vs 52.5%, p=0.70; mortality 26.3% vs 18.0%, p=0.43). Notably, there were no difference in outcomes in FPE versus non-FPE mTICI 2c/3 patients. CONCLUSION: Twenty-eight percent of patients undergoing anterior LVO thrombectomy and 24% of patients undergoing basilar artery occlusion thrombectomy experience FPE. Independent predictors of FPE in anterior circulation LVO thrombectomy include higher ASITN levels, higher ASPECTS, and the presence of atrial fibrillation.
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a ischemie mozku $x diagnostické zobrazování $x chirurgie $7 D002545
650    _2
$a cerebrovaskulární poruchy $x diagnostické zobrazování $x chirurgie $7 D002561
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a ischemická cévní mozková příhoda $x diagnostické zobrazování $x chirurgie $7 D000083242
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a prospektivní studie $7 D011446
650    12
$a registrace $7 D012042
650    _2
$a trombektomie $x metody $7 D017131
650    _2
$a výsledek terapie $7 D016896
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
700    1_
$a Desai, Shashvat M $u Department of Neurology and Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA $u Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
700    1_
$a Budzik, Ronald F $u Riverside Methodist Hospital, Columbus, Ohio, USA
700    1_
$a Gupta, Rishi $u Department of Neurology, WellStar Health System, Marietta, Georgia, USA
700    1_
$a Baxter, Blaise $u Department of Radiology, Erlanger Medical Center, Chattanooga, Tennessee, USA
700    1_
$a English, Joey D $u California Pacific Medical Center, San Francisco, California, USA
700    1_
$a Bartolini, Bruno Mario $u Department of Neuroradiology, CHUV, Lausanne, VD, Switzerland
700    1_
$a Krajina, Antonin $u Department of Radiology, Hradec Kralove, Czech Republic
700    1_
$a Haussen, Diogo C $u Department of Neurology, Neurosurgery, and Radiology, Emory University School of Medicine/Marcus Stroke & Neuroscience Center - Grady Memorial Hospital, Atlanta, Florida, USA
700    1_
$a Nogueira, Raul G $u Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
700    1_
$a Liebeskind, David $u Department of Neurology, UCLA, Los Angeles, California, USA
700    1_
$a Veznedaroglu, Erol $u Department of Neuroscience, Drexel University, Philadelphia, Pennsylvania, USA
773    0_
$w MED00179154 $t Journal of neurointerventional surgery $x 1759-8486 $g Roč. 13, č. 7 (2021), s. 619-622
856    41
$u https://pubmed.ncbi.nlm.nih.gov/33479032 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20211013 $b ABA008
991    __
$a 20211026133804 $b ABA008
999    __
$a ok $b bmc $g 1714498 $s 1145975
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2021 $b 13 $c 7 $d 619-622 $e 20210121 $i 1759-8486 $m Journal of neurointerventional surgery $n J Neurointerv Surg $x MED00179154
LZP    __
$a Pubmed-20211013
Back

Find record

Citation metrics

Archiving options