Outcomes of Rescue Endovascular Treatment of Emergent Large Vessel Occlusion in Patients With Underlying Intracranial Atherosclerosis: Insights From STAR.

Authors

• Sami Al Kasab
• Eyad Almallouhi
• Ali Alawieh
• Stacey Wolfe
• Kyle M Fargen
• Adam S Arthur
• Nitin Goyal
• Travis Dumont
• Peter Kan
• Joon-Tae Kim
• Reade De Leacy
• Ilko Maier
• Joshua Osbun
• Ansaar Rai
• Pascal Jabbour
• Jonathan A Grossberg
• Min S Park
• Robert M Starke
• Roberto Crosa
• Alejandro M Spiotta

Publication/Presentation Date

6-15-2021

Abstract

Background Some emergent large vessel occlusions (ELVOs) are refractory to reperfusion because of underlying intracranial atherosclerosis (ICAS), often requiring rescue therapy (RT) with balloon angioplasty, stenting, or both. In this study, we investigate the safety, efficacy, and long-term outcomes of RT in the setting of mechanical thrombectomy for ICAS-related ELVO. Methods and Results We queried the databases of 10 thrombectomy-capable centers in North America and Europe included in STAR (Stroke Thrombectomy and Aneurysm Registry). Patients with ELVO who underwent ICAS-related RT were included. A matched sample was produced for variables of age, admission National Institute of Health Stroke Scale, Alberta Stroke Program Early CT Score, onset to groin puncture time, occlusion site, and final recanalization. Out of 3025 patients with MT, 182 (6%) patients required RT because of underlying ICAS. Balloon angioplasty was performed on 122 patients, and 117 patients had intracranial stenting. In the matched analysis, 141 patients who received RT matched to a similar number of controls. The number of thrombectomy passes was higher (3 versus 1,

Volume

10

Issue

12

First Page

020195

Last Page

020195

ISSN

2047-9980

Published In/Presented At

Al Kasab, S., Almallouhi, E., Alawieh, A., Wolfe, S., Fargen, K. M., Arthur, A. S., Goyal, N., Dumont, T., Kan, P., Kim, J. T., De Leacy, R., Maier, I., Osbun, J., Rai, A., Jabbour, P., Grossberg, J. A., Park, M. S., Starke, R. M., Crosa, R., Spiotta, A. M., … STAR collaborators † (2021). Outcomes of Rescue Endovascular Treatment of Emergent Large Vessel Occlusion in Patients With Underlying Intracranial Atherosclerosis: Insights From STAR. Journal of the American Heart Association, 10(12), e020195. https://doi.org/10.1161/JAHA.120.020195

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

34096337

Department(s)

Administration and Leadership

Document Type

Article