Thrombus perviousness is not associated with first-pass revascularization using stent retrievers
Background and purpose Recent studies suggest that thrombus imaging characteristics such as Hounsfield unit (HU) and perviousness assessed on noncontrast computed tomography (NCCT) and CT angiography (CTA) can predict successful recanalization. We assessed whether these thrombus imaging characterist...
Gespeichert in:
| Veröffentlicht in: | Interventional neuroradiology 2019-06, Vol.25 (3), p.285-290 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 290 |
|---|---|
| container_issue | 3 |
| container_start_page | 285 |
| container_title | Interventional neuroradiology |
| container_volume | 25 |
| creator | Byun, Jun-Soo Nicholson, Patrick Hilditch, Christopher A Chun On Tsang, Anderson Mendes Pereira, Vitor Krings, Timo Fang, Yibin Brinjikji, Waleed |
| description | Background and purpose
Recent studies suggest that thrombus imaging characteristics such as Hounsfield unit (HU) and perviousness assessed on noncontrast computed tomography (NCCT) and CT angiography (CTA) can predict successful recanalization. We assessed whether these thrombus imaging characteristics could predict successful first-pass recanalization.
Methods
We retrospectively reviewed cases of mechanical thrombectomy over a three-year period in which patients received a multiphase CTA and were treated with a stent retriever on first pass. Thrombus attenuation, thrombus enhancement on arterial- and delayed-phase CTA and percentage washout were calculated and their association with first-pass recanalization, successful recanalization and distal embolic complications was studied.
Results
Fifty-two mechanical thrombectomy patients were included. First-pass recanalization was achieved in 59.6% and complete revascularization (Thrombolysis in Cerebral Infarction scale 2b/3) was achieved in 84.6%. There was no correlation between first-pass recanalization with thrombus density on NCCT (p = 0.94), percentage enhancement on arterial (p = 0.61) and delayed-phase CTA (p = 0.23) or thrombus length (p = 0.16). There was no correlation between number of passes and either thrombus density on NCCT (p = 0.91) or percentage enhancement on arterial- (p = 0.79) and delayed-phase (p = 0.14) CTA or thrombus length (p = 0.34). Clot length was significantly higher in patients with distal embolic complications than in those without (18.5 ± 7.9 vs 11.4 ± 6.6 mm, p = 0.005).
Conclusions
Our data suggest that thrombus imaging characteristics on multiphase CTA cannot predict first-pass recanalization or successful revascularization in acute ischemic stroke patients treated with stent retrievers. Longer clot length was associated with higher risk of distal embolic complications. |
| doi_str_mv | 10.1177/1591019918825444 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6547211</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1591019918825444</sage_id><sourcerecordid>2179484999</sourcerecordid><originalsourceid>FETCH-LOGICAL-c434t-1c188df1b6bc64302d7b8ef2b0e050aa73a0a355d7d26658b67125e7e8c8cd3c3</originalsourceid><addsrcrecordid>eNp1UU2LFDEQDaK44-rdk-TopTWVj073RZDFL1jwsp5jOl09k6WnM6bSI_rrzTDrooKngnqvXr2qx9hzEK8ArH0NpgcBfQ9dJ43W-gHbSNWZRgqAh2xzgpsTfsGeEN0K0RrVw2N2oYQFbQRs2NebXU77YSV-wHyMaaUFiXgkvqTCPVEK0Rcc-fdYdnyKmUpzqG2e8egprLPP8acvMS18pbhsORVcSkVLjnjETE_Zo8nPhM_u6iX78v7dzdXH5vrzh09Xb6-boJUuDYR6wzjB0A6h1UrI0Q4dTnIQKIzw3iovvDJmtKNsW9MNrQVp0GIXujCqoC7Zm7PuYR32OIbqIvvZHXLc-_zDJR_d38gSd26bjq412kqAKvDyTiCnbytScftIAefZL1jf4iTYXne67_tKFWdqyIko43S_BoQ7BeP-DaaOvPjT3v3A7yQqoTkTyG_R3aY1L_Vd_xf8BcEZmT8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2179484999</pqid></control><display><type>article</type><title>Thrombus perviousness is not associated with first-pass revascularization using stent retrievers</title><source>Access via SAGE</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Byun, Jun-Soo ; Nicholson, Patrick ; Hilditch, Christopher A ; Chun On Tsang, Anderson ; Mendes Pereira, Vitor ; Krings, Timo ; Fang, Yibin ; Brinjikji, Waleed</creator><creatorcontrib>Byun, Jun-Soo ; Nicholson, Patrick ; Hilditch, Christopher A ; Chun On Tsang, Anderson ; Mendes Pereira, Vitor ; Krings, Timo ; Fang, Yibin ; Brinjikji, Waleed</creatorcontrib><description>Background and purpose
Recent studies suggest that thrombus imaging characteristics such as Hounsfield unit (HU) and perviousness assessed on noncontrast computed tomography (NCCT) and CT angiography (CTA) can predict successful recanalization. We assessed whether these thrombus imaging characteristics could predict successful first-pass recanalization.
Methods
We retrospectively reviewed cases of mechanical thrombectomy over a three-year period in which patients received a multiphase CTA and were treated with a stent retriever on first pass. Thrombus attenuation, thrombus enhancement on arterial- and delayed-phase CTA and percentage washout were calculated and their association with first-pass recanalization, successful recanalization and distal embolic complications was studied.
Results
Fifty-two mechanical thrombectomy patients were included. First-pass recanalization was achieved in 59.6% and complete revascularization (Thrombolysis in Cerebral Infarction scale 2b/3) was achieved in 84.6%. There was no correlation between first-pass recanalization with thrombus density on NCCT (p = 0.94), percentage enhancement on arterial (p = 0.61) and delayed-phase CTA (p = 0.23) or thrombus length (p = 0.16). There was no correlation between number of passes and either thrombus density on NCCT (p = 0.91) or percentage enhancement on arterial- (p = 0.79) and delayed-phase (p = 0.14) CTA or thrombus length (p = 0.34). Clot length was significantly higher in patients with distal embolic complications than in those without (18.5 ± 7.9 vs 11.4 ± 6.6 mm, p = 0.005).
Conclusions
Our data suggest that thrombus imaging characteristics on multiphase CTA cannot predict first-pass recanalization or successful revascularization in acute ischemic stroke patients treated with stent retrievers. Longer clot length was associated with higher risk of distal embolic complications.</description><identifier>ISSN: 1591-0199</identifier><identifier>EISSN: 2385-2011</identifier><identifier>DOI: 10.1177/1591019918825444</identifier><identifier>PMID: 30714501</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Cerebral Angiography ; Cerebral Revascularization - adverse effects ; Cerebral Revascularization - methods ; Female ; Humans ; Intracranial Embolism - etiology ; Intracranial Embolism - therapy ; Intracranial Thrombosis - etiology ; Intracranial Thrombosis - pathology ; Ischemic Stroke ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Stents - adverse effects ; Stroke - surgery ; Thrombectomy ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Interventional neuroradiology, 2019-06, Vol.25 (3), p.285-290</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019 2019 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-1c188df1b6bc64302d7b8ef2b0e050aa73a0a355d7d26658b67125e7e8c8cd3c3</citedby><cites>FETCH-LOGICAL-c434t-1c188df1b6bc64302d7b8ef2b0e050aa73a0a355d7d26658b67125e7e8c8cd3c3</cites><orcidid>0000-0003-2758-3253 ; 0000-0001-5271-5524</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547211/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547211/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,21828,27933,27934,43630,43631,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30714501$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Byun, Jun-Soo</creatorcontrib><creatorcontrib>Nicholson, Patrick</creatorcontrib><creatorcontrib>Hilditch, Christopher A</creatorcontrib><creatorcontrib>Chun On Tsang, Anderson</creatorcontrib><creatorcontrib>Mendes Pereira, Vitor</creatorcontrib><creatorcontrib>Krings, Timo</creatorcontrib><creatorcontrib>Fang, Yibin</creatorcontrib><creatorcontrib>Brinjikji, Waleed</creatorcontrib><title>Thrombus perviousness is not associated with first-pass revascularization using stent retrievers</title><title>Interventional neuroradiology</title><addtitle>Interv Neuroradiol</addtitle><description>Background and purpose
Recent studies suggest that thrombus imaging characteristics such as Hounsfield unit (HU) and perviousness assessed on noncontrast computed tomography (NCCT) and CT angiography (CTA) can predict successful recanalization. We assessed whether these thrombus imaging characteristics could predict successful first-pass recanalization.
Methods
We retrospectively reviewed cases of mechanical thrombectomy over a three-year period in which patients received a multiphase CTA and were treated with a stent retriever on first pass. Thrombus attenuation, thrombus enhancement on arterial- and delayed-phase CTA and percentage washout were calculated and their association with first-pass recanalization, successful recanalization and distal embolic complications was studied.
Results
Fifty-two mechanical thrombectomy patients were included. First-pass recanalization was achieved in 59.6% and complete revascularization (Thrombolysis in Cerebral Infarction scale 2b/3) was achieved in 84.6%. There was no correlation between first-pass recanalization with thrombus density on NCCT (p = 0.94), percentage enhancement on arterial (p = 0.61) and delayed-phase CTA (p = 0.23) or thrombus length (p = 0.16). There was no correlation between number of passes and either thrombus density on NCCT (p = 0.91) or percentage enhancement on arterial- (p = 0.79) and delayed-phase (p = 0.14) CTA or thrombus length (p = 0.34). Clot length was significantly higher in patients with distal embolic complications than in those without (18.5 ± 7.9 vs 11.4 ± 6.6 mm, p = 0.005).
Conclusions
Our data suggest that thrombus imaging characteristics on multiphase CTA cannot predict first-pass recanalization or successful revascularization in acute ischemic stroke patients treated with stent retrievers. Longer clot length was associated with higher risk of distal embolic complications.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cerebral Angiography</subject><subject>Cerebral Revascularization - adverse effects</subject><subject>Cerebral Revascularization - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Embolism - etiology</subject><subject>Intracranial Embolism - therapy</subject><subject>Intracranial Thrombosis - etiology</subject><subject>Intracranial Thrombosis - pathology</subject><subject>Ischemic Stroke</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Stents - adverse effects</subject><subject>Stroke - surgery</subject><subject>Thrombectomy</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>1591-0199</issn><issn>2385-2011</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UU2LFDEQDaK44-rdk-TopTWVj073RZDFL1jwsp5jOl09k6WnM6bSI_rrzTDrooKngnqvXr2qx9hzEK8ArH0NpgcBfQ9dJ43W-gHbSNWZRgqAh2xzgpsTfsGeEN0K0RrVw2N2oYQFbQRs2NebXU77YSV-wHyMaaUFiXgkvqTCPVEK0Rcc-fdYdnyKmUpzqG2e8egprLPP8acvMS18pbhsORVcSkVLjnjETE_Zo8nPhM_u6iX78v7dzdXH5vrzh09Xb6-boJUuDYR6wzjB0A6h1UrI0Q4dTnIQKIzw3iovvDJmtKNsW9MNrQVp0GIXujCqoC7Zm7PuYR32OIbqIvvZHXLc-_zDJR_d38gSd26bjq412kqAKvDyTiCnbytScftIAefZL1jf4iTYXne67_tKFWdqyIko43S_BoQ7BeP-DaaOvPjT3v3A7yQqoTkTyG_R3aY1L_Vd_xf8BcEZmT8</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Byun, Jun-Soo</creator><creator>Nicholson, Patrick</creator><creator>Hilditch, Christopher A</creator><creator>Chun On Tsang, Anderson</creator><creator>Mendes Pereira, Vitor</creator><creator>Krings, Timo</creator><creator>Fang, Yibin</creator><creator>Brinjikji, Waleed</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2758-3253</orcidid><orcidid>https://orcid.org/0000-0001-5271-5524</orcidid></search><sort><creationdate>20190601</creationdate><title>Thrombus perviousness is not associated with first-pass revascularization using stent retrievers</title><author>Byun, Jun-Soo ; Nicholson, Patrick ; Hilditch, Christopher A ; Chun On Tsang, Anderson ; Mendes Pereira, Vitor ; Krings, Timo ; Fang, Yibin ; Brinjikji, Waleed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-1c188df1b6bc64302d7b8ef2b0e050aa73a0a355d7d26658b67125e7e8c8cd3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cerebral Angiography</topic><topic>Cerebral Revascularization - adverse effects</topic><topic>Cerebral Revascularization - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Embolism - etiology</topic><topic>Intracranial Embolism - therapy</topic><topic>Intracranial Thrombosis - etiology</topic><topic>Intracranial Thrombosis - pathology</topic><topic>Ischemic Stroke</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Stents - adverse effects</topic><topic>Stroke - surgery</topic><topic>Thrombectomy</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Byun, Jun-Soo</creatorcontrib><creatorcontrib>Nicholson, Patrick</creatorcontrib><creatorcontrib>Hilditch, Christopher A</creatorcontrib><creatorcontrib>Chun On Tsang, Anderson</creatorcontrib><creatorcontrib>Mendes Pereira, Vitor</creatorcontrib><creatorcontrib>Krings, Timo</creatorcontrib><creatorcontrib>Fang, Yibin</creatorcontrib><creatorcontrib>Brinjikji, Waleed</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Interventional neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Byun, Jun-Soo</au><au>Nicholson, Patrick</au><au>Hilditch, Christopher A</au><au>Chun On Tsang, Anderson</au><au>Mendes Pereira, Vitor</au><au>Krings, Timo</au><au>Fang, Yibin</au><au>Brinjikji, Waleed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thrombus perviousness is not associated with first-pass revascularization using stent retrievers</atitle><jtitle>Interventional neuroradiology</jtitle><addtitle>Interv Neuroradiol</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>25</volume><issue>3</issue><spage>285</spage><epage>290</epage><pages>285-290</pages><issn>1591-0199</issn><eissn>2385-2011</eissn><abstract>Background and purpose
Recent studies suggest that thrombus imaging characteristics such as Hounsfield unit (HU) and perviousness assessed on noncontrast computed tomography (NCCT) and CT angiography (CTA) can predict successful recanalization. We assessed whether these thrombus imaging characteristics could predict successful first-pass recanalization.
Methods
We retrospectively reviewed cases of mechanical thrombectomy over a three-year period in which patients received a multiphase CTA and were treated with a stent retriever on first pass. Thrombus attenuation, thrombus enhancement on arterial- and delayed-phase CTA and percentage washout were calculated and their association with first-pass recanalization, successful recanalization and distal embolic complications was studied.
Results
Fifty-two mechanical thrombectomy patients were included. First-pass recanalization was achieved in 59.6% and complete revascularization (Thrombolysis in Cerebral Infarction scale 2b/3) was achieved in 84.6%. There was no correlation between first-pass recanalization with thrombus density on NCCT (p = 0.94), percentage enhancement on arterial (p = 0.61) and delayed-phase CTA (p = 0.23) or thrombus length (p = 0.16). There was no correlation between number of passes and either thrombus density on NCCT (p = 0.91) or percentage enhancement on arterial- (p = 0.79) and delayed-phase (p = 0.14) CTA or thrombus length (p = 0.34). Clot length was significantly higher in patients with distal embolic complications than in those without (18.5 ± 7.9 vs 11.4 ± 6.6 mm, p = 0.005).
Conclusions
Our data suggest that thrombus imaging characteristics on multiphase CTA cannot predict first-pass recanalization or successful revascularization in acute ischemic stroke patients treated with stent retrievers. Longer clot length was associated with higher risk of distal embolic complications.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>30714501</pmid><doi>10.1177/1591019918825444</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2758-3253</orcidid><orcidid>https://orcid.org/0000-0001-5271-5524</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1591-0199 |
| ispartof | Interventional neuroradiology, 2019-06, Vol.25 (3), p.285-290 |
| issn | 1591-0199 2385-2011 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6547211 |
| source | Access via SAGE; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Aged Aged, 80 and over Cerebral Angiography Cerebral Revascularization - adverse effects Cerebral Revascularization - methods Female Humans Intracranial Embolism - etiology Intracranial Embolism - therapy Intracranial Thrombosis - etiology Intracranial Thrombosis - pathology Ischemic Stroke Male Middle Aged Predictive Value of Tests Retrospective Studies Stents - adverse effects Stroke - surgery Thrombectomy Tomography, X-Ray Computed Treatment Outcome |
| title | Thrombus perviousness is not associated with first-pass revascularization using stent retrievers |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-02T00%3A06%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Thrombus%20perviousness%20is%20not%20associated%20with%20first-pass%20revascularization%20using%20stent%20retrievers&rft.jtitle=Interventional%20neuroradiology&rft.au=Byun,%20Jun-Soo&rft.date=2019-06-01&rft.volume=25&rft.issue=3&rft.spage=285&rft.epage=290&rft.pages=285-290&rft.issn=1591-0199&rft.eissn=2385-2011&rft_id=info:doi/10.1177/1591019918825444&rft_dat=%3Cproquest_pubme%3E2179484999%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2179484999&rft_id=info:pmid/30714501&rft_sage_id=10.1177_1591019918825444&rfr_iscdi=true |