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First pass effect as an independent predictor of functional outcomes in medium vessel occlusions: an analysis of an international multicenter study

Introduction: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and pred...

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Hauptverfasser: Radu, Răzvan Alexandru (VerfasserIn) , Costalat, Vincent (VerfasserIn) , Fahed, Robert (VerfasserIn) , Ghozy, Sherief (VerfasserIn) , Siegler, James E (VerfasserIn) , Shaikh, Hamza (VerfasserIn) , Khalife, Jane (VerfasserIn) , Abdalkader, Mohamad (VerfasserIn) , Klein, Piers (VerfasserIn) , Nguyen, Thanh N (VerfasserIn) , Heit, Jeremy J (VerfasserIn) , Sweid, Ahmad (VerfasserIn) , El Naamani, Kareem (VerfasserIn) , Regenhardt, Robert W (VerfasserIn) , Diestro, Jose Danilo Bengzon (VerfasserIn) , Cancelliere, Nicole M (VerfasserIn) , Amllay, Abdelaziz (VerfasserIn) , Meyer, Lukas (VerfasserIn) , Dusart, Anne (VerfasserIn) , Bellante, Flavio (VerfasserIn) , Forestier, Géraud (VerfasserIn) , Rouchaud, Aymeric (VerfasserIn) , Saleme, Suzana (VerfasserIn) , Mounayer, Charbel (VerfasserIn) , Fiehler, Jens (VerfasserIn) , Kühn, Anna Luisa (VerfasserIn) , Puri, Ajit S (VerfasserIn) , Dyzmann, Christian (VerfasserIn) , Kan, Peter T (VerfasserIn) , Colasurdo, Marco (VerfasserIn) , Marnat, Gaultier (VerfasserIn) , Berge, Jérôme (VerfasserIn) , Barreau, Xavier (VerfasserIn) , Sibon, Igor (VerfasserIn) , Nedelcu, Simona (VerfasserIn) , Henninger, Nils (VerfasserIn) , Kyheng, Maéva (VerfasserIn) , Marotta, Thomas R (VerfasserIn) , Stapleton, Christopher J (VerfasserIn) , Rabinov, James D (VerfasserIn) , Ota, Takahiro (VerfasserIn) , Dofuku, Shogo (VerfasserIn) , Yeo, Leonard LL (VerfasserIn) , Tan, Benjamin YQ (VerfasserIn) , Martinez-Gutierrez, Juan Carlos (VerfasserIn) , Salazar-Marioni, Sergio (VerfasserIn) , Sheth, Sunil (VerfasserIn) , Renieri, Leonardo (VerfasserIn) , Capirossi, Carolina (VerfasserIn) , Mowla, Ashkan (VerfasserIn) , Tjoumakaris, Stavropoula I (VerfasserIn) , Jabbour, Pascal (VerfasserIn) , Khandelwal, Priyank (VerfasserIn) , Biswas, Arundhati (VerfasserIn) , Clarençon, Frédéric (VerfasserIn) , Elhorany, Mahmoud (VerfasserIn) , Premat, Kevin (VerfasserIn) , Valente, Iacopo (VerfasserIn) , Pedicelli, Alessandro (VerfasserIn) , Pedro Filipe, João (VerfasserIn) , Varela, Ricardo (VerfasserIn) , Quintero-Consuegra, Miguel (VerfasserIn) , Gonzalez, Nestor R (VerfasserIn) , Möhlenbruch, Markus Alfred (VerfasserIn) , Jesser, Jessica (VerfasserIn) , Tancredi, Illario (VerfasserIn) , ter Schiphorst, Adrien (VerfasserIn) , Yedavalli, Vivek (VerfasserIn) , Harker, Pablo (VerfasserIn) , Chervak, Lina M (VerfasserIn) , Aziz, Yasmin (VerfasserIn) , Gory, Benjamin (VerfasserIn) , Paul Stracke, Christian (VerfasserIn) , Hecker, Constantin (VerfasserIn) , Killer-Oberpfalzer, Monika (VerfasserIn) , Griessenauer, Christoph J (VerfasserIn) , Thomas, Ajith J (VerfasserIn) , Hsieh, Cheng-Yang (VerfasserIn) , Liebeskind, David S. (VerfasserIn) , Alexandre, Andrea M (VerfasserIn) , Faizy, Tobias D (VerfasserIn) , Weyland, Charlotte S. (VerfasserIn) , Patel, Aman B (VerfasserIn) , Pereira, Vitor Mendes (VerfasserIn) , Lubicz, Boris (VerfasserIn) , Dmytriw, Adam A (VerfasserIn) , Guenego, Adrien (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: March 2024
In: European stroke journal
Year: 2024, Jahrgang: 9, Heft: 1, Pages: 114-123
ISSN:2396-9881
DOI:10.1177/23969873231208276
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/23969873231208276
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/23969873231208276
Volltext
Verfasserangaben:Răzvan Alexandru Radu, Vincent Costalat, Robert Fahed, Sherief Ghozy, James E Siegler, Hamza Shaikh, Jane Khalife, Mohamad Abdalkader, Piers Klein, Thanh N Nguyen, Jeremy J Heit, Ahmad Sweid, Kareem El Naamani, Robert W Regenhardt, Jose Danilo Bengzon Diestro, Nicole M Cancelliere, Abdelaziz Amllay, Lukas Meyer, Anne Dusart, Flavio Bellante, Géraud Forestier, Aymeric Rouchaud, Suzana Saleme, Charbel Mounayer, Jens Fiehler, Anna Luisa Kühn, Ajit S Puri, Christian Dyzmann, Peter T Kan, Marco Colasurdo, Gaultier Marnat, Jérôme Berge, Xavier Barreau, Igor Sibon, Simona Nedelcu, Nils Henninger, Maéva Kyheng, Thomas R Marotta, Christopher J Stapleton, James D Rabinov, Takahiro Ota, Shogo Dofuku, Leonard LL Yeo, Benjamin YQ Tan, Juan Carlos Martinez-Gutierrez, Sergio Salazar-Marioni, Sunil Sheth, Leonardo Renieri, Carolina Capirossi, Ashkan Mowla, Stavropoula I Tjoumakaris, Pascal Jabbour, Priyank Khandelwal, Arundhati Biswas, Frédéric Clarençon, Mahmoud Elhorany, Kevin Premat, Iacopo Valente, Alessandro Pedicelli, João Pedro Filipe, Ricardo Varela, Miguel Quintero-Consuegra, Nestor R Gonzalez, Markus A Möhlenbruch, Jessica Jesser, Illario Tancredi, Adrien ter Schiphorst, Vivek Yedavalli, Pablo Harker, Lina M Chervak, Yasmin Aziz, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Monika Killer-Oberpfalzer, Christoph J Griessenauer, Ajith J Thomas, Cheng-Yang Hsieh, David S Liebeskind, Andrea M Alexandre, Tobias D Faizy, Charlotte Weyland, Aman B Patel, Vitor Mendes Pereira, Boris Lubicz, Adam A Dmytriw, and Adrien Guenego; for the MAD-MT Consortium
Beschreibung
Zusammenfassung:Introduction: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce. - Patients and Methods: We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale 0-2 at 3 months. - Results: Eight hundred thirty-six patients with a final mTICI ⩾ 2b were included in this analysis. FPE was observed in 302 patients (36.1%). In multivariable analysis, hypertension (aOR 1.55, 95% CI 1.10-2.20) and lower baseline NIHSS score (aOR 0.95, 95% CI 0.93-0.97) were independently associated with an FPE. Good outcomes were more common in the FPE versus non-FPE group (72.8% vs 52.8%), and FPE was independently associated with favorable outcome (aOR 2.20, 95% CI 1.59-3.05). 90-day mortality and intracranial hemorrhage (ICH) were significantly lower in the FPE group, 0.43 (95% CI, 0.25-0.72) and 0.55 (95% CI, 0.39-0.77), respectively. - Conclusion: Over 2/3 of patients with MeVOs and FPE in our cohort had a favorable outcome at 90 days. FPE is independently associated with favorable outcomes, it may reduce the risk of any intracranial hemorrhage, and 3-month mortality.
Beschreibung:Online veröffentlicht: 27. Oktober 2023
Gesehen am 30.09.2024
Beschreibung:Online Resource
ISSN:2396-9881
DOI:10.1177/23969873231208276

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