Aspiration Versus Stent-Retriever as First-Line Endovascular Therapy Technique for Primary Medium and Distal Intracranial Occlusions: A Propensity-Score Matched Multicenter Analysis.
Publication/Presentation Date
11-1-2023
Abstract
BACKGROUND: For acute proximal intracranial artery occlusions, contact aspiration may be more effective than stent-retriever for first-line reperfusion therapy. Due to the lack of data regarding medium vessel occlusion thrombectomy, we evaluated outcomes according to first-line technique in a large, multicenter registry.
METHODS: Imaging, procedural, and clinical outcomes of patients with acute proximal medium vessel occlusions (M2, A1, or P1) or distal medium vessel occlusions (M3, A2, P2, or further) treated at 37 sites in 10 countries were analyzed according to first-line endovascular technique (stent-retriever versus aspiration). Multivariable logistic regression and propensity-score matching were used to estimate the odds of the primary outcome, expanded Thrombolysis in Cerebral Infarction score of 2b-3 ("successful recanalization"), as well as secondary outcomes (first-pass effect, expanded Thrombolysis in Cerebral Infarction 2c-3, intracerebral hemorrhage, and 90-day modified Rankin scale, 90-day mortality) between treatment groups.
RESULTS: Of the 440 included patients (44.5% stent-retriever versus 55.5% aspiration), those treated with stent-retriever had lower baseline Alberta Stroke Program Early Computed Tomography Scale scores (median 8 versus 9;
CONCLUSION: In this large, diverse, multinational medium vessel occlusion cohort, we found no significant difference in imaging or clinical outcomes with aspiration versus stent-retriever thrombectomy.
Volume
3
Issue
6
First Page
000931
Last Page
000931
ISSN
2694-5746
Published In/Presented At
Siegler, J. E., Shaikh, H., Khalife, J., Oak, S., Zhang, L., Abdalkader, M., Klein, P., Nguyen, T. N., Kass-Hout, T., Morsi, R. Z., Heit, J. J., Regenhardt, R. W., Diestro, J. D. B., Cancelliere, N. M., Ghozy, S., Sweid, A., Naamani, K. E., Amllay, A., Meyer, L., Dusart, A., … MAD‐MT Consortium (2023). Aspiration Versus Stent-Retriever as First-Line Endovascular Therapy Technique for Primary Medium and Distal Intracranial Occlusions: A Propensity-Score Matched Multicenter Analysis. Stroke (Hoboken, N.J.), 3(6), e000931. https://doi.org/10.1161/SVIN.123.000931
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41585056
Department(s)
Administration and Leadership
Document Type
Article