Title :

Identifying the predictors of first-pass effect and its influence on clinical outcome in the setting of endovascular thrombectomy for acute ischemic stroke: Results from a multicentric prospective registry.

Author(s) :

Di Maria, Frederico [Auteur]
Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
Kyheng, MaÉva [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Consoli, Arturo [Auteur]
Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
Desilles, Jean-Philippe [Auteur]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Gory, Benjamin [Auteur]
Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
Richard, Sébastien [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Rodesch, Georges [Auteur]
Hôpital Foch [Suresnes]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Girot, Jean-Baptiste [Auteur]
Département de Neuro-Radiologie [Angers] [DNR - Angers]
Dargazanli, Cyril [Auteur]
Département de Neuroradiologie[Montpellier]
Marnat, Gaultier [Auteur]
Département de Neuro-Radiologie [Bordeaux] [DNR - Bordeaux]
Lapergue, Bertrand [Auteur]
Service de neuroradiologie [Suresnes]
Bourcier, Romain [Auteur]
Service de neurologie [Nantes]

Journal title :

Int J Stroke

Abbreviated title :

Int J Stroke

Volume number :

16

Pages :

20-28

Publication date :

2020-05-10

ISSN :

1747-4949

English keyword(s) :

Acute
acute stroke therapy
intervention
ischaemic stroke
reperfusion
stroke units

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background The first-pass effect, defined as a complete or near-complete recanalization after one pass (first-pass effect) of a mechanical thrombectomy device, has been related to better clinical outcome than good ...
Show more >Background The first-pass effect, defined as a complete or near-complete recanalization after one pass (first-pass effect) of a mechanical thrombectomy device, has been related to better clinical outcome than good recanalization after more than one pass in acute ischemic stroke. We searched for predictors of first-pass effect by analyzing the results within a large prospective multicentric registry. Methods We included patients treated by mechanical thrombectomy for isolated anterior intracranial occlusions. A multi-variate logistic regression analysis was carried out to search for predictors of first-pass effect. We also analyzed the percentage of patients with 90-day modified Rankin Scale score 0 to 2, excellent outcome (90-day modified Rankin Scale 0 to 1), 24-h NIHSS change, and 90-day all-cause mortality. Results Among the 1832 patients included, clinical outcome at 90 days was significantly better in first-pass effect patients (50.6% vs. 38.9% in patients without first-pass effect), with a center-adjusted OR associated with first-pass effect of 1.74 (95%CI, 1.24 to 1.77). Older age, a lower systolic blood pressure, an MCA-M1 occlusion, higher DWI-ASPECTS at admission, mechanical thrombectomy under local anesthesia, and combined first-line device strategy were independent predictors of first-pass effect. Conclusions In this study, a strategy combining thrombectomy and thrombo-aspiration was more effective than other strategies in achieving first-pass effect. In addition, we confirm that clinical outcome was better in patients with first-pass effect compared to non-first-pass effect patients.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

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

Submission date :

2023-11-15T08:55:28Z
2023-12-12T14:32:06Z