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Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion
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| Zeitschriftentitel: | Frontiers in Neurology |
|---|---|
| Personen und Körperschaften: | , , , , , , , , |
| In: | Frontiers in Neurology, 12, 2021 |
| Format: | E-Article |
| Sprache: | Unbestimmt |
| veröffentlicht: |
Frontiers Media SA
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| Schlagwörter: |
| author_facet |
Kaiser, Daniel Krukowski, Pawel Hädrich, Kevin Winzer, Robert Pallesen, Lars-Peder Gawlitza, Matthias Linn, Jennifer Puetz, Volker Gerber, Johannes C. Kaiser, Daniel Krukowski, Pawel Hädrich, Kevin Winzer, Robert Pallesen, Lars-Peder Gawlitza, Matthias Linn, Jennifer Puetz, Volker Gerber, Johannes C. |
|---|---|
| author |
Kaiser, Daniel Krukowski, Pawel Hädrich, Kevin Winzer, Robert Pallesen, Lars-Peder Gawlitza, Matthias Linn, Jennifer Puetz, Volker Gerber, Johannes C. |
| spellingShingle |
Kaiser, Daniel Krukowski, Pawel Hädrich, Kevin Winzer, Robert Pallesen, Lars-Peder Gawlitza, Matthias Linn, Jennifer Puetz, Volker Gerber, Johannes C. Frontiers in Neurology Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion Neurology (clinical) Neurology |
| author_sort |
kaiser, daniel |
| spelling |
Kaiser, Daniel Krukowski, Pawel Hädrich, Kevin Winzer, Robert Pallesen, Lars-Peder Gawlitza, Matthias Linn, Jennifer Puetz, Volker Gerber, Johannes C. 1664-2295 Frontiers Media SA Neurology (clinical) Neurology http://dx.doi.org/10.3389/fneur.2021.666933 <jats:p><jats:bold>Objective:</jats:bold> To assess whether angiographic thrombus surface phenotype has an impact on efficacy of contact aspiration (CA) thrombectomy in patients with basilar artery occlusion (BAO).</jats:p><jats:p><jats:bold>Methods:</jats:bold> From January 2016 to December 2019, consecutive stroke patients with a BAO and first-line CA were analyzed in this retrospective study. We assessed baseline and imaging characteristics and treatment and clinical outcomes. We rated thrombus surface phenotype on pre-treatment digital subtraction angiography in a three-reader-consensus setting. Primary outcome was complete recanalization (modified treatment in cerebral ischemia [mTICI] 3 and arterial occlusive lesion [AOL] 3) after first-line CA without additionally stent retriever passes. Data analysis was stratified according to thrombus surface phenotype and complete first-line recanalization.</jats:p><jats:p><jats:bold>Results:</jats:bold> Seventy-eight patients met the inclusion criteria. Median age was 74 years (IQR 64–80), 64% were male, and median baseline NIHSS score was 24 (IQR 7–32). Thirty patients had a regular and 16 patients had an irregular thrombus phenotype. Thrombus surface was not assessable in 32 patients. In patients with a regular phenotype, complete recanalization was more often achieved compared to irregular and non-ratable phenotypes (50 vs. 18.8% and 21.9%; <jats:italic>p</jats:italic> = 0.027). Patients with a regular phenotype [odds ratio [OR] 8.3; 95% confidence interval [CI]: 1.9–35.8; <jats:italic>p</jats:italic> = 0.005], cardioembolic stroke (OR 12.1, 95% CI: 2.0–72.8; <jats:italic>p</jats:italic> = 0.007), and proximal end of the thrombus in the middle basilar artery segment (OR 5.2, 95% CI: 1.0–26.6; <jats:italic>p</jats:italic> = 0.046) were more likely to achieve complete recanalization after first-line CA without rescue therapy.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The efficacy of CA may differ according to the angiographic thrombus surface phenotype in patients with BAO. A regular phenotype is associated with higher rates of complete recanalization in first-line CA. However, assessment of thrombus phenotype is frequently not feasible in BAO.</jats:p> Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion Frontiers in Neurology |
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10.3389/fneur.2021.666933 |
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Frontiers Media SA, 2021 |
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Frontiers Media SA, 2021 |
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1664-2295 |
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| title |
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_unstemmed |
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_full |
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_fullStr |
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_full_unstemmed |
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_short |
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_sort |
association of regular thrombus surface phenotype with complete recanalization in first-line contact aspiration thrombectomy for basilar artery occlusion |
| topic |
Neurology (clinical) Neurology |
| url |
http://dx.doi.org/10.3389/fneur.2021.666933 |
| publishDate |
2021 |
| physical |
|
| description |
<jats:p><jats:bold>Objective:</jats:bold> To assess whether angiographic thrombus surface phenotype has an impact on efficacy of contact aspiration (CA) thrombectomy in patients with basilar artery occlusion (BAO).</jats:p><jats:p><jats:bold>Methods:</jats:bold> From January 2016 to December 2019, consecutive stroke patients with a BAO and first-line CA were analyzed in this retrospective study. We assessed baseline and imaging characteristics and treatment and clinical outcomes. We rated thrombus surface phenotype on pre-treatment digital subtraction angiography in a three-reader-consensus setting. Primary outcome was complete recanalization (modified treatment in cerebral ischemia [mTICI] 3 and arterial occlusive lesion [AOL] 3) after first-line CA without additionally stent retriever passes. Data analysis was stratified according to thrombus surface phenotype and complete first-line recanalization.</jats:p><jats:p><jats:bold>Results:</jats:bold> Seventy-eight patients met the inclusion criteria. Median age was 74 years (IQR 64–80), 64% were male, and median baseline NIHSS score was 24 (IQR 7–32). Thirty patients had a regular and 16 patients had an irregular thrombus phenotype. Thrombus surface was not assessable in 32 patients. In patients with a regular phenotype, complete recanalization was more often achieved compared to irregular and non-ratable phenotypes (50 vs. 18.8% and 21.9%; <jats:italic>p</jats:italic> = 0.027). Patients with a regular phenotype [odds ratio [OR] 8.3; 95% confidence interval [CI]: 1.9–35.8; <jats:italic>p</jats:italic> = 0.005], cardioembolic stroke (OR 12.1, 95% CI: 2.0–72.8; <jats:italic>p</jats:italic> = 0.007), and proximal end of the thrombus in the middle basilar artery segment (OR 5.2, 95% CI: 1.0–26.6; <jats:italic>p</jats:italic> = 0.046) were more likely to achieve complete recanalization after first-line CA without rescue therapy.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The efficacy of CA may differ according to the angiographic thrombus surface phenotype in patients with BAO. A regular phenotype is associated with higher rates of complete recanalization in first-line CA. However, assessment of thrombus phenotype is frequently not feasible in BAO.</jats:p> |
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| author | Kaiser, Daniel, Krukowski, Pawel, Hädrich, Kevin, Winzer, Robert, Pallesen, Lars-Peder, Gawlitza, Matthias, Linn, Jennifer, Puetz, Volker, Gerber, Johannes C. |
| author_facet | Kaiser, Daniel, Krukowski, Pawel, Hädrich, Kevin, Winzer, Robert, Pallesen, Lars-Peder, Gawlitza, Matthias, Linn, Jennifer, Puetz, Volker, Gerber, Johannes C., Kaiser, Daniel, Krukowski, Pawel, Hädrich, Kevin, Winzer, Robert, Pallesen, Lars-Peder, Gawlitza, Matthias, Linn, Jennifer, Puetz, Volker, Gerber, Johannes C. |
| author_sort | kaiser, daniel |
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| description | <jats:p><jats:bold>Objective:</jats:bold> To assess whether angiographic thrombus surface phenotype has an impact on efficacy of contact aspiration (CA) thrombectomy in patients with basilar artery occlusion (BAO).</jats:p><jats:p><jats:bold>Methods:</jats:bold> From January 2016 to December 2019, consecutive stroke patients with a BAO and first-line CA were analyzed in this retrospective study. We assessed baseline and imaging characteristics and treatment and clinical outcomes. We rated thrombus surface phenotype on pre-treatment digital subtraction angiography in a three-reader-consensus setting. Primary outcome was complete recanalization (modified treatment in cerebral ischemia [mTICI] 3 and arterial occlusive lesion [AOL] 3) after first-line CA without additionally stent retriever passes. Data analysis was stratified according to thrombus surface phenotype and complete first-line recanalization.</jats:p><jats:p><jats:bold>Results:</jats:bold> Seventy-eight patients met the inclusion criteria. Median age was 74 years (IQR 64–80), 64% were male, and median baseline NIHSS score was 24 (IQR 7–32). Thirty patients had a regular and 16 patients had an irregular thrombus phenotype. Thrombus surface was not assessable in 32 patients. In patients with a regular phenotype, complete recanalization was more often achieved compared to irregular and non-ratable phenotypes (50 vs. 18.8% and 21.9%; <jats:italic>p</jats:italic> = 0.027). Patients with a regular phenotype [odds ratio [OR] 8.3; 95% confidence interval [CI]: 1.9–35.8; <jats:italic>p</jats:italic> = 0.005], cardioembolic stroke (OR 12.1, 95% CI: 2.0–72.8; <jats:italic>p</jats:italic> = 0.007), and proximal end of the thrombus in the middle basilar artery segment (OR 5.2, 95% CI: 1.0–26.6; <jats:italic>p</jats:italic> = 0.046) were more likely to achieve complete recanalization after first-line CA without rescue therapy.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The efficacy of CA may differ according to the angiographic thrombus surface phenotype in patients with BAO. A regular phenotype is associated with higher rates of complete recanalization in first-line CA. However, assessment of thrombus phenotype is frequently not feasible in BAO.</jats:p> |
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| imprint | Frontiers Media SA, 2021 |
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| institution | DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1, DE-L229, DE-D275, DE-Bn3, DE-Brt1, DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4 |
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| spelling | Kaiser, Daniel Krukowski, Pawel Hädrich, Kevin Winzer, Robert Pallesen, Lars-Peder Gawlitza, Matthias Linn, Jennifer Puetz, Volker Gerber, Johannes C. 1664-2295 Frontiers Media SA Neurology (clinical) Neurology http://dx.doi.org/10.3389/fneur.2021.666933 <jats:p><jats:bold>Objective:</jats:bold> To assess whether angiographic thrombus surface phenotype has an impact on efficacy of contact aspiration (CA) thrombectomy in patients with basilar artery occlusion (BAO).</jats:p><jats:p><jats:bold>Methods:</jats:bold> From January 2016 to December 2019, consecutive stroke patients with a BAO and first-line CA were analyzed in this retrospective study. We assessed baseline and imaging characteristics and treatment and clinical outcomes. We rated thrombus surface phenotype on pre-treatment digital subtraction angiography in a three-reader-consensus setting. Primary outcome was complete recanalization (modified treatment in cerebral ischemia [mTICI] 3 and arterial occlusive lesion [AOL] 3) after first-line CA without additionally stent retriever passes. Data analysis was stratified according to thrombus surface phenotype and complete first-line recanalization.</jats:p><jats:p><jats:bold>Results:</jats:bold> Seventy-eight patients met the inclusion criteria. Median age was 74 years (IQR 64–80), 64% were male, and median baseline NIHSS score was 24 (IQR 7–32). Thirty patients had a regular and 16 patients had an irregular thrombus phenotype. Thrombus surface was not assessable in 32 patients. In patients with a regular phenotype, complete recanalization was more often achieved compared to irregular and non-ratable phenotypes (50 vs. 18.8% and 21.9%; <jats:italic>p</jats:italic> = 0.027). Patients with a regular phenotype [odds ratio [OR] 8.3; 95% confidence interval [CI]: 1.9–35.8; <jats:italic>p</jats:italic> = 0.005], cardioembolic stroke (OR 12.1, 95% CI: 2.0–72.8; <jats:italic>p</jats:italic> = 0.007), and proximal end of the thrombus in the middle basilar artery segment (OR 5.2, 95% CI: 1.0–26.6; <jats:italic>p</jats:italic> = 0.046) were more likely to achieve complete recanalization after first-line CA without rescue therapy.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The efficacy of CA may differ according to the angiographic thrombus surface phenotype in patients with BAO. A regular phenotype is associated with higher rates of complete recanalization in first-line CA. However, assessment of thrombus phenotype is frequently not feasible in BAO.</jats:p> Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion Frontiers in Neurology |
| spellingShingle | Kaiser, Daniel, Krukowski, Pawel, Hädrich, Kevin, Winzer, Robert, Pallesen, Lars-Peder, Gawlitza, Matthias, Linn, Jennifer, Puetz, Volker, Gerber, Johannes C., Frontiers in Neurology, Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion, Neurology (clinical), Neurology |
| title | Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_full | Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_fullStr | Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_full_unstemmed | Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_short | Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| title_sort | association of regular thrombus surface phenotype with complete recanalization in first-line contact aspiration thrombectomy for basilar artery occlusion |
| title_unstemmed | Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion |
| topic | Neurology (clinical), Neurology |
| url | http://dx.doi.org/10.3389/fneur.2021.666933 |