Objective:
Emboli commonly occurs in mechanical thrombectomy (MT). The objective
of this study was to analyze predicting factors of emboli after MT.
background:
N/A
Methods:
Patients who underwent MT with successful reperfusion for anterior circulation occlusion
were enrolled. Emboli included distal emboli at digital subtraction angiography (DSA) and
unexpected embolic infarct on diffusion-weighted image (DWI) without distal emboli at DSA.
Baseline characteristics, procedural details, angiographic outcomes, and clinical outcomes were
reviewed. Multivariable analyses were performed to evaluate predictive factors for the occurrence
of emboli.
objective:
Emboli commonly occurs in mechanical thrombectomy (MT). The objective of this study was to analyze predicting factors of emboli after MT.
Results:
Of 601 patients, 149 (24.8%) patients had distal emboli at DSA, and 169 (28.1%) patients
had unexpected embolic infarction on DWI even without distal emboli at DSA. A total of
318 (52.9%) patients were enrolled in the embolic group, and 283 (47.1%) patients were assigned
to the non-embolic group. In multivariate analysis, larger microcatheter (OR 1.26, 95%
CI 1.12–1.94; p = 0.047), clot passage (OR 1.33, 95% CI 1.07–1.87; p = 0.041), use of balloon
guide catheter (BGC) (OR 0.70, 95% CI 0.52–0.92; p = 0.014), early ballooning of BGC (OR
0.68, 95% CI 0.50–0.90; p = 0.009), and longer stent retriever (OR 0.72, 95% CI 0.54–0.90; p =
0.029) were associated with occurrence of emboli.
Conclusion:
MT with only a stent retriever, use of a larger microcatheter, and clot passage
might increase the risk of emboli. In contrast, contact aspiration thrombectomy, use of BGC,
early ballooning of BGC, and use of longer stent retrievers could reduce the chance of emboli.