계명대학교 의학도서관 Repository

Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy

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Affiliated Author(s)
유준상
Alternative Author(s)
Yoo, Joon Sang
Journal Title
Journal of NeuroInterventional Surgery
ISSN
1759-8486
Issued Date
2019
Abstract
Backgroud
The need for rescue treatment (RT) may differ depending on first-line modality (stent retriever (SR) or contact aspiration (CA)) in endovascular thrombectomy (EVT). We aimed to investigate whether the type of first-line modality in EVT was associated with the need for RT.

Methods
We identified all patients who underwent EVT for anterior circulation large-vessel occlusion from prospectively maintained registries of 17 stroke centers. Patients were dichotomized into SR-first and CA-first. RT involved switching to the other device, balloon angioplasty, permanent stenting, thrombolytics, glycoprotein IIb/IIIa antagonist, or any combination of these. We compared clinical characteristics, procedural details, and final recanalization rate between the two groups and assessed whether first-line modality type was associated with RT requirement and if this affected clinical outcome.

Results
A total of 955 patients underwent EVT using either SR-first (n=526) or CA-first (n=429). No difference occurred in the final recanalization rate between SR-first (82.1%) and CA-first (80.2%). However, recanalization with the first-line modality alone and first-pass recanalization rates were significantly higher in SR-first than in CA-first. CA-first had more device passes and higher RT rate. The RT group had significantly longer puncture-to-recanalization time (93±48 min versus 53±28 min). After adjustment, CA-first remained associated with RT (OR, 1.367; 95% CI , 1.019 to 1.834). RT was negatively associated with good outcome (OR, 0.597; 95% CI , 0.410 to 0.870).

Conclusion
CA was associated with requiring RT, while recanalization with first-line modality alone and firstpass recanalization rates were higher with SR. RT was negatively associated with good outcome.
Department
Dept. of Neurology (신경과학)
Publisher
School of Medicine (의과대학)
Citation
Dong-Hun Kang et al. (2019). Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy. Journal of NeuroInterventional Surgery, 11(10), 979–983. doi: 10.1136/neurintsurg-2018-014696
Type
Article
ISSN
1759-8486
DOI
10.1136/neurintsurg-2018-014696
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41950
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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