2022
DOI: 10.1136/neurintsurg-2022-018715
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Abstract: BackgroundThe number of mechanical thrombectomy (MT) passes is strongly associated with angiographic reperfusion as well as clinical outcomes in patients with anterior circulation ischemic stroke. However, these associations have not been analyzed in patients with basilar artery occlusion (BAO). We investigated the influence of the number of MT passes on the degree of reperfusion and clinical outcomes, and compared outcome after ≤3 passes versus >3 passes.MethodsWe used data from the prospective multicentri… Show more

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Cited by 5 publications
(4 citation statements)
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“…36 Treatment failure is a significant concern for all EVT methods with failure to achieve recanalization observed in approximately 10%-15% of BAO patients. 16,37 Similar to anterior LVO stroke, the first-pass effect 38,39 is observed in BAO occlusion 40 with the odds of failed recanalization and subsequent poor neurological outcome increasing for every additional pass. The benefits of EVT in BAO may be attenuated when more than 3 passes are required for recanalization.…”
Section: Discussionmentioning
confidence: 96%
See 1 more Smart Citation
“…36 Treatment failure is a significant concern for all EVT methods with failure to achieve recanalization observed in approximately 10%-15% of BAO patients. 16,37 Similar to anterior LVO stroke, the first-pass effect 38,39 is observed in BAO occlusion 40 with the odds of failed recanalization and subsequent poor neurological outcome increasing for every additional pass. The benefits of EVT in BAO may be attenuated when more than 3 passes are required for recanalization.…”
Section: Discussionmentioning
confidence: 96%
“…The benefits of EVT in BAO may be attenuated when more than 3 passes are required for recanalization. 37 Angioplasty with or without stenting has been demonstrated to prevent unsuccessful EVT in patients after the failure of another technique. 41,42 In 1 retrospective study of patients who underwent EVT for BAO, angioplasty prevented treatment failure in 65 of 188 successfully reperfused patients.…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, LeCouffe et al 28 The post hoc analysis of Endovascular Treatment in Ischemic Stroke registry has found that stent retriever passes ≤3 were benefit for patients with basilar artery occlusion, but those >3 did not; however, patients included in this study were all within 24 hours from onset to puncture time. 29 In our subgroup analysis, patients were divided into the early time window and the late time window groups according to onset to puncture time. Notably, we found that stent retriever passes were associated with futile recanalization in patients with late time windows, but there was no significant difference between stent retriever passes and futile recanalization in patients with the early time windows.…”
Section: Discussionmentioning
confidence: 99%
“…[IQR], 63 [54-71] years vs 65 [58-74] years; P = .02), had a higher systolic blood pressure on admission (median[IQR], 146 mm Hg vs 151 [135-169] mm Hg; P = .03), higher neutrophil-to-lymphocyte ratio (NLR) (median [IQR], 6.3 [4.1-10.2] vs 9.2[5.8-13.4]; P < .001), higher baseline NIHSS score (median [IQR], 18[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] vs 30[21][22][23][24][25][26][27][28][29][30][31][32][33][34]; P < .001), lower baseline pc-ASPECTS score (median [IQR], 9[8][9][10] vs 8[6][7][8][9]; P < .001), lower PC-CS score (median [IQR], 5[4][5][6] vs 4 [3-6]; P < .001), and longer puncture to recanalization time (PTR) (median [IQR], 87 [62-128] minutes vs 110 [11-155] minutes; P < .001). In addition, the proportions of patients with diabetes mellitus (87 of 328 patients [26.5%] vs 21 of 194 patients [16.0%]; P = .005), coronary heart disease (59 of 328 patients [18.0%] vs 21 of 194 patients [10.8%]; P = .03), and symptomatic intracranial hemorrhage (24 of 328 patients [7.4%] vs 3 of 194 patients [1.5%]; P = .004) in the futile recanalization group were higher than those in the meaningful recanalization group.…”
mentioning
confidence: 99%