Title :

First pass effect with contact aspiration and stent retrievers in the aspiration versus stent retriever (aster) trial

Author(s) :

Ducroux, Celina [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Piotin, Michel [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Gory, Benjamin [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Blanc, Raphael [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Ben Maacha, Malek [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Lapergue, Bertrand [Auteur]
Service de neuroradiologie [Suresnes]
Fahed, Robert [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]

Journal title :

Journal of neurointerventional surgery

Abbreviated title :

J Neurointerv Surg

Volume number :

12

Pages :

386-391

Publication date :

2019-08-30

ISSN :

1759-8486

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: The 'first pass effect' (FPE), which was originally described with stent retrievers, designates a (near-)complete revascularization obtained after a single device pass with no rescue therapy, and is associated ...
Show more >BACKGROUND: The 'first pass effect' (FPE), which was originally described with stent retrievers, designates a (near-)complete revascularization obtained after a single device pass with no rescue therapy, and is associated with improved clinical outcome and decreased mortality. OBJECTIVE: We report the rate and benefits of FPE in the Aspiration versus Stent Retriever (ASTER) trial. METHODS: ASTER is a randomized trial comparing angiographic revascularization with the stent retriever (SR) and contact aspiration (CA) thrombectomy techniques, assessed by an external core laboratory using the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Rates of FPE (defined by mTICI 2c/3 after a single pass with no rescue therapy) were compared between patients treated with SR and CA techniques. Outcomes were compared between FPE-SR and FPE-CA patients, and between FPE and non-FPE patients. RESULTS: FPE was achieved in 97/336 patients (28.9%), with no significant difference between SR and CA (respectively 53/169 patients (31.3%) vs 44/167 patients (26.3%), adjusted RR for CA versus SR 0.84, 95% CI 0.54 to 1.31; p=0.44). After prespecified adjustment for allocated arm and randomization stratification factors, FPE in patients was associated with a significantly improved clinical outcome and a decreased mortality, and a significantly lower rate of hemorrhagic transformation and procedural complications than in non-FPE patients. CONCLUSIONS: In the ASTER trial, similar rates of FPE were achieved with SR and CA, and FPE was associated with a significantly improved outcome. New techniques and devices to improve the rate of FPE are warranted. BACKGROUND: Unique identifier: NCT02523261.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:47:54Z
2020-03-20T17:09:57Z
2020-03-25T09:33:22Z
2020-03-25T09:35:12Z