Long and Large Stentrievers Improve Reperfusion Outcomes in Acute Intracranial Terminal Internal Carotid Artery Occlusion: Interim Results of the Rossetti Registry.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY

Clinical Neuroradiology Pub Date : 2024-12-13 DOI:10.1007/s00062-024-01486-0

Antonio Lopez-Rueda, Josep Puig, Pepus Daunis-I-Estadella, Mariano Werner, Eva González, Ion Labayen, Pedro Vega, Eduardo Murias, Elvira Jimenez-Gomez, Isabel Bravo Rey, Manuel Moreu, Carlos Pérez-García, Oscar Chirife Chaparro, Sonia Aixut, Mikel Terceño, Guillem Dolz, José Manuel Pumar, Yeray Aguilar Tejedor, Jose Carlos Mendez, Fernando Aparici-Robles, Lluis Morales-Caba, José Carlos Rayón, Luis San Roman, Jordi Blasco

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引用次数: 0

Abstract

Introduction: Although stentrievers (SRs) are widely used for mechanical thrombectomy (MT), the impact of device dimensions on optimizing reperfusion outcomes in high clot burden cases is unclear. Our study aimed to investigate the effect of SR size on angiographic and clinical outcomes in patients with acute terminal internal cerebral artery (TICA) occlusion.

Methods: We analyzed ROSSETTI registry data to compare technical and clinical outcomes of TICA occlusion patients treated with MT without rescue therapy, according to SR diameter and length: 6 × 41-50 mm, 6 × 20-40 mm, and <6 × 20-50 mm. The first-pass effect (FPE) was defined as achieving a TICI2c‑3 after a single pass.

Results: We included 491 patients, 240 (41.5%) in 6 × 41-50 group, 117 (20.2%) in 6 × 20-40 group, and 134 (23.2%) in < 6 × 20-50 group. The MT procedure time for the 6 × 41-50 group was shorter, but the FPE rate was similar across all groups. The highest final mTICI 2c‑3 rate was in 6 × 41-50 group (81.2%), compared to 6 × 20-40 group (68.4%) and 4-6 × 20-50 group (72.4%) (p = 0.016). Distal catheter use was associated with final mTICI 0-2b (62% of patients). Clinical outcomes were similar between the groups. Larger diameter and longer length of the SR, as well as not using an intermediate catheter, were independent predictors of final mTICI 2c‑3. The use of 6 × 41-50 SRs (OR 1.64, 95% CI 1.06-2.52; p = 0.024) and distal catheter use (OR 0.62, 95%CI 0.40-0.96; p = 0.034) were independent predictors of final mTICI 2c‑3.

Conclusions: Use of longer and larger SRs in acute intracranial TICA occlusion improves final reperfusion rate.

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长型和大型支架取栓器改善了急性颅内末端颈内动脉闭塞的再灌注效果：Rossetti 登记的中期结果。

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来源期刊

Clinical Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

5.00

自引率

3.60%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects. The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.