A comparison between different endovascular treatment strategies for acute large vessel occlusion due to intracranial artery atherosclerosis: data from ANGEL-ACT Registry

Zhang, Jingyu; Jia, Baixue; Pan, Yuesong; Yu, Zequan; Deng, Yiming; Mo, Dapeng; Ma, Ning; Gao, Feng; Miao, Zhongrong

doi:10.1007/s00234-022-02933-w

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…86 Zhang et al compared the outcomes of three EVT strategies (first-line MT with rescue angioplasty/stenting, direct angioplasty/stenting without MT, and MT alone) for ICAD-LVO, and suggested direct angioplasty/stenting without MT was an effective option for cases in which ICAD-LVO was strongly suspected before the procedure. 87…”

Section: Endovascular Treatment For Icad-lvomentioning

confidence: 99%

Endovascular Treatment for Acute Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Disease

Huo,

Sun,

Chen

et al. 2023

Semin Neurol

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Intracranial atherosclerotic disease (ICAD) is one of the most common causes of acute ischemic stroke worldwide. Patients with acute large vessel occlusion due to underlying ICAD (ICAD-LVO) often do not achieve successful recanalization when undergoing mechanical thrombectomy (MT) alone, requiring rescue treatment, including intra-arterial thrombolysis, balloon angioplasty, and stenting. Therefore, early detection of ICAD-LVO before the procedure is important to enable physicians to select the optimal treatment strategy for ICAD-LVO to improve clinical outcomes. Early diagnosis of ICAD-LVO is challenging in the absence of consensus diagnostic criteria on noninvasive imaging and early digital subtraction angiography. In this review, we summarize the clinical and diagnostic criteria, prediction of ICAD-LVO prior to the procedure, and EVT strategy of ICAD-LVO and provide recommendations according to the current literature.

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Section: Endovascular Treatment For Icad-lvomentioning

confidence: 99%

Endovascular Treatment for Acute Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Disease

Huo,

Sun,

Chen

et al. 2023

Semin Neurol

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“…Though certain studies have demonstrated the feasibility of direct angioplasty for patients with ICAS-ELVO [11][12][13][14] , these studies did not define the clot burden of the included patients. The microcatheter "first-pass effect" is considered a valid predictor of ICAS-ELVO 15 , and it often suggests an occluded vessel with a small clot burden.…”

Section: Introductionmentioning

confidence: 99%

Balloon Angioplasty as the First-Choice Treatment for Intracranial Atherosclerosis-Related Emergent Large Vessel Occlusion Involving the Microcatheter “First-Pass Effect”

Zhang

huang

liu

2023

Preprint

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Background: It is unknown whether balloon angioplasty can be a first choice treatment for intracranial atherosclerosis related emergent large vessel occlusion (ICASELVO) with small clot burden. The microcatheter first pass effect is a valid predictor of ICAS-ELVO with small clot. Objective: To determine balloon angioplasty efficacy as first choice treatment for ICASELVO involving the microcatheter first pass effect during endovascular treatment (EVT). Methods: This continuous retrospective analysis assessed ICASELVO patients presenting with the microcatheter first pass effect during EVT. Patients were divided into two first choice treatment based groups: preferred balloon angioplasty (PBA) and preferred mechanical thrombectomy (PMT). Efficacy and safety outcomes were compared between groups. Results: Seventy six patients with ICAS-ELVO involving the microcatheter first pass effect during EVT were enrolled. Compared with patients in PMT group, patients in PBA group were associated with (i) a higher rate of first pass recanalization (54.0% vs. 28.9%, p=.010) and complete reperfusion (expanded thrombolysis in cerebral ischemia;2c; 76.0% vs. 53.8%, p=.049), (ii) a shorter puncture to recanalization time (49.5 min vs. 56.0 min, p<.001), (iii) less operation costs (48,499.5 vs. 99,086.0, p<.001),and (iv) more excellent functional outcomes (modified Rankin scale:0-1; 44.0% vs. 19.2%, p=.032) at 90 days. No significant differences in symptomatic intracranial hemorrhage (12.0% vs. 15.4%, p>.999) and mortality (10.0% vs. 7.7%, p>.999) were noted. Logistic regression analysis revealed that first choice treatment was an independent predictor of 90 day excellent functional outcomes (adjusted odds ratio [aOR] =0.10, 95% CI: 0.02~0.66, p=.017). Conclusion: Balloon angioplasty, as the first choice treatment, potentially improves 90 day functional outcomes for ICASELVO patients with microcatheter first-pass effect during EVT.

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Angioplasty, stenting, or both — rescue maneuvers and reperfusion after endovascular therapy for intracranial atherosclerosis-related occlusion

et al. 2023

View full text Add to dashboard Cite

A comparison between different endovascular treatment strategies for acute large vessel occlusion due to intracranial artery atherosclerosis: data from ANGEL-ACT Registry

Cited by 5 publications

References 36 publications

Endovascular Treatment for Acute Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Disease

Endovascular Treatment for Acute Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Disease

Balloon Angioplasty as the First-Choice Treatment for Intracranial Atherosclerosis-Related Emergent Large Vessel Occlusion Involving the Microcatheter “First-Pass Effect”

Angioplasty, stenting, or both — rescue maneuvers and reperfusion after endovascular therapy for intracranial atherosclerosis-related occlusion

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