Effects of first pass recanalization on outcomes of contact aspiration thrombectomy

Dong Hun Kang, Byung Moon Kim, Ji Hoe Heo, Hyo Suk Nam, Young Dae Kim, Yang Ha Hwang, Yong Won Kim, Dong Joon Kim, Joon Whi Kim, Jang Hyun Baek, Yong Sun Kim

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Abstract

Background First pass recanalization (FPR, defined as achieving a modified Thrombolysis in Cerebral Ischemia (mTICI) grade 2c/3 with a single pass of a thrombectomy device) effect has not yet been evaluated in contact aspiration thrombectomy (CAT). We evaluated FPR effect on clinical outcomes and FPR predictors in CAT. Methods All consecutive patients who underwent frontline CAT for anterior circulation large vessel occlusion with recanalization (mTICI 2b-3) were identified from registries at six stroke centers. The patients were dichotomized into FPR and non-FPR groups. Clinical features and outcomes were compared between the groups. Multivariate analyses were performed to determine whether FPR was independently associated with clinical outcomes and to identify predictors of FPR. Results Of the 429 patients who underwent frontline CAT, recanalization was successful in 344 patients (80.2%; mean age 68.7±11.0 years; M:F ratio 179:165). The FPR group had a higher rate of good outcome (modified Rankin Scale score 0-2) than the non-FPR group. Furthermore, the good outcome rate was higher in the FPR group than in patients who achieved mTICI 2c/3 with multiple passes or rescue treatment. FPR (OR 2.587; 95% CI 1.237 to 5.413) remained independently associated with good outcomes, in addition to age, baseline National Institute Health Stroke Scale, and coronary artery disease. The use of a balloon guide catheter (OR 3.071; 95% CI 1.699 to 5.550) was the only predictor of FPR. Conclusions Patients in the FPR group had better clinical outcomes than the non-FPR group in CAT. FPR was independently associated with a good outcome. The use of a balloon guide catheter was the only predictor of FPR.

Original languageEnglish
Pages (from-to)466-470
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume12
Issue number5
DOIs
Publication statusPublished - 2020 May 1

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Kang, D. H., Kim, B. M., Heo, J. H., Nam, H. S., Kim, Y. D., Hwang, Y. H., Kim, Y. W., Kim, D. J., Kim, J. W., Baek, J. H., & Kim, Y. S. (2020). Effects of first pass recanalization on outcomes of contact aspiration thrombectomy. Journal of NeuroInterventional Surgery, 12(5), 466-470. https://doi.org/10.1136/neurintsurg-2019-015221