Predictive value of computed tomography angiography-determined occlusion type in stent retriever thrombectomy

Jang Hyun Baek, Byungmoon Kim, Joonsang Yoo, Hyo Suk Nam, Young Dae Kim, Dong Joon Kim, Jihoe Heo, Oh Young Bang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background and Purpose-We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. Methods-Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment. Three rapidly- and readily-assessable pre-procedural findings (CTA-determined occlusion type, atrial fibrillation, and hyperdense artery sign), which may infer occlusion pathomechanism (embolic versus nonembolic) before endovascular treatment, were evaluated for association with SR success along with stroke risk factors and laboratory results. In addition, the predictive power of the 3 pre-procedural findings for SR success was compared with receiver operating characteristic curve analyses. Results-A total of 238 patients (mean age, 70.0 years; male patients, 52.9%) were included in this study. CTA-determined occlusion type corresponded adequately with digital subtraction angiography-determined occlusion type (P=0.453). Atrial fibrillation (odds ratio, 2.66; 95% confidence interval, 1.25-5.66) and CTA-determined branching-site occlusion (odds ratio, 8.20; confidence interval, 3.45-19.5) were independent predictors for SR success. For predicting SR success, the area under the receiver operating characteristic curve value for CTA-determined branching-site occlusion (0.695) was significantly greater than atrial fibrillation (0.594; P=0.038) and hyperdense artery sign (0.603; P=0.023). Conclusions-CTA-determined branching-site occlusion was significantly associated with SR success. Furthermore, among the 3 rapidly- and readily-assessable pre-procedural findings, CTA-determined branching-site occlusion had the greatest predictive power for SR success. (Stroke. 2017;48:2746-2752. DOI: 10.1161/STROKEAHA.117.018096).

Original languageEnglish
Pages (from-to)2746-2752
Number of pages7
JournalStroke
Volume48
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1

Fingerprint

Thrombectomy
Stents
Atrial Fibrillation
Digital Subtraction Angiography
Arteries
Stroke
ROC Curve
Odds Ratio
Confidence Intervals
Therapeutics
Computed Tomography Angiography

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Baek, Jang Hyun ; Kim, Byungmoon ; Yoo, Joonsang ; Nam, Hyo Suk ; Kim, Young Dae ; Kim, Dong Joon ; Heo, Jihoe ; Bang, Oh Young. / Predictive value of computed tomography angiography-determined occlusion type in stent retriever thrombectomy. In: Stroke. 2017 ; Vol. 48, No. 10. pp. 2746-2752.
@article{7532589f7e954e6e86bada691480fed6,
title = "Predictive value of computed tomography angiography-determined occlusion type in stent retriever thrombectomy",
abstract = "Background and Purpose-We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. Methods-Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment. Three rapidly- and readily-assessable pre-procedural findings (CTA-determined occlusion type, atrial fibrillation, and hyperdense artery sign), which may infer occlusion pathomechanism (embolic versus nonembolic) before endovascular treatment, were evaluated for association with SR success along with stroke risk factors and laboratory results. In addition, the predictive power of the 3 pre-procedural findings for SR success was compared with receiver operating characteristic curve analyses. Results-A total of 238 patients (mean age, 70.0 years; male patients, 52.9{\%}) were included in this study. CTA-determined occlusion type corresponded adequately with digital subtraction angiography-determined occlusion type (P=0.453). Atrial fibrillation (odds ratio, 2.66; 95{\%} confidence interval, 1.25-5.66) and CTA-determined branching-site occlusion (odds ratio, 8.20; confidence interval, 3.45-19.5) were independent predictors for SR success. For predicting SR success, the area under the receiver operating characteristic curve value for CTA-determined branching-site occlusion (0.695) was significantly greater than atrial fibrillation (0.594; P=0.038) and hyperdense artery sign (0.603; P=0.023). Conclusions-CTA-determined branching-site occlusion was significantly associated with SR success. Furthermore, among the 3 rapidly- and readily-assessable pre-procedural findings, CTA-determined branching-site occlusion had the greatest predictive power for SR success. (Stroke. 2017;48:2746-2752. DOI: 10.1161/STROKEAHA.117.018096).",
author = "Baek, {Jang Hyun} and Byungmoon Kim and Joonsang Yoo and Nam, {Hyo Suk} and Kim, {Young Dae} and Kim, {Dong Joon} and Jihoe Heo and Bang, {Oh Young}",
year = "2017",
month = "10",
day = "1",
doi = "10.1161/STROKEAHA.117.018096",
language = "English",
volume = "48",
pages = "2746--2752",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

Predictive value of computed tomography angiography-determined occlusion type in stent retriever thrombectomy. / Baek, Jang Hyun; Kim, Byungmoon; Yoo, Joonsang; Nam, Hyo Suk; Kim, Young Dae; Kim, Dong Joon; Heo, Jihoe; Bang, Oh Young.

In: Stroke, Vol. 48, No. 10, 01.10.2017, p. 2746-2752.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictive value of computed tomography angiography-determined occlusion type in stent retriever thrombectomy

AU - Baek, Jang Hyun

AU - Kim, Byungmoon

AU - Yoo, Joonsang

AU - Nam, Hyo Suk

AU - Kim, Young Dae

AU - Kim, Dong Joon

AU - Heo, Jihoe

AU - Bang, Oh Young

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background and Purpose-We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. Methods-Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment. Three rapidly- and readily-assessable pre-procedural findings (CTA-determined occlusion type, atrial fibrillation, and hyperdense artery sign), which may infer occlusion pathomechanism (embolic versus nonembolic) before endovascular treatment, were evaluated for association with SR success along with stroke risk factors and laboratory results. In addition, the predictive power of the 3 pre-procedural findings for SR success was compared with receiver operating characteristic curve analyses. Results-A total of 238 patients (mean age, 70.0 years; male patients, 52.9%) were included in this study. CTA-determined occlusion type corresponded adequately with digital subtraction angiography-determined occlusion type (P=0.453). Atrial fibrillation (odds ratio, 2.66; 95% confidence interval, 1.25-5.66) and CTA-determined branching-site occlusion (odds ratio, 8.20; confidence interval, 3.45-19.5) were independent predictors for SR success. For predicting SR success, the area under the receiver operating characteristic curve value for CTA-determined branching-site occlusion (0.695) was significantly greater than atrial fibrillation (0.594; P=0.038) and hyperdense artery sign (0.603; P=0.023). Conclusions-CTA-determined branching-site occlusion was significantly associated with SR success. Furthermore, among the 3 rapidly- and readily-assessable pre-procedural findings, CTA-determined branching-site occlusion had the greatest predictive power for SR success. (Stroke. 2017;48:2746-2752. DOI: 10.1161/STROKEAHA.117.018096).

AB - Background and Purpose-We investigated whether occlusion type identified with computed tomography angiography (CTA-determined occlusion type) could predict endovascular treatment success using stent retriever (SR) thrombectomy. Methods-Consecutive patients with stroke who underwent CTA and then endovascular treatment for intracranial large artery occlusion were retrospectively reviewed. CTA-determined occlusion type was classified into truncal-type occlusion or branching-site occlusion and compared with digital subtraction angiography-determined occlusion type during endovascular treatment. Three rapidly- and readily-assessable pre-procedural findings (CTA-determined occlusion type, atrial fibrillation, and hyperdense artery sign), which may infer occlusion pathomechanism (embolic versus nonembolic) before endovascular treatment, were evaluated for association with SR success along with stroke risk factors and laboratory results. In addition, the predictive power of the 3 pre-procedural findings for SR success was compared with receiver operating characteristic curve analyses. Results-A total of 238 patients (mean age, 70.0 years; male patients, 52.9%) were included in this study. CTA-determined occlusion type corresponded adequately with digital subtraction angiography-determined occlusion type (P=0.453). Atrial fibrillation (odds ratio, 2.66; 95% confidence interval, 1.25-5.66) and CTA-determined branching-site occlusion (odds ratio, 8.20; confidence interval, 3.45-19.5) were independent predictors for SR success. For predicting SR success, the area under the receiver operating characteristic curve value for CTA-determined branching-site occlusion (0.695) was significantly greater than atrial fibrillation (0.594; P=0.038) and hyperdense artery sign (0.603; P=0.023). Conclusions-CTA-determined branching-site occlusion was significantly associated with SR success. Furthermore, among the 3 rapidly- and readily-assessable pre-procedural findings, CTA-determined branching-site occlusion had the greatest predictive power for SR success. (Stroke. 2017;48:2746-2752. DOI: 10.1161/STROKEAHA.117.018096).

UR - http://www.scopus.com/inward/record.url?scp=85031030397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031030397&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.117.018096

DO - 10.1161/STROKEAHA.117.018096

M3 - Article

VL - 48

SP - 2746

EP - 2752

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 10

ER -