Background: The significance of early venous filling (EVF) after mechanical thrombectomy (MT) in acute ischemic stroke (AIS) is not fully understood. In this study, we aimed to investigate the impact of EVF after MT.
Methods: From January 2019 to May 2022, AIS patients with successful recanalization (modified Thrombolysis in Cerebral Infarction score (mTICI) ≥2b) after MT were retrospectively reviewed. EVF was evaluated on final digital subtraction angiography runs after successful recanalization and was categorized into phase subgroups (arterial phase and capillary phase) and pathway subgroups (cortical veins subgroup and thalamostriate veins subgroup), respectively. The impact of EVF subgroups on functional outcomes after successful recanalization were both investigated.
Results: A total of 349 patients achieving successful recanalization after MT were included, including 45 patients in the EVF group and 304 patients in the non-EVF group. Multivariable logistic regression analysis showed the EVF group had a higher rate of intracranial hemorrhage (ICH; 66.7% vs 22%, adjusted odds ratio (aOR) 6.805, 95% CI 3.389 to 13.662, P<0.001), symptomatic ICH (sICH; 28.9% vs 4.9%, aOR 6.011, 95% CI 2.493 to 14.494, P<0.001) and malignant cerebral edema (MCE; 20% vs 6.9%, aOR 2.682, 95% CI 1.086 to 6.624, P=0.032) than the non-EVF group. Furthermore, the cortical veins subgroup of EVF had a higher rate of mortality than the thalamostriate veins subgroup (37.5% vs 10.3%, P=0.029).
Conclusions: EVF is independently associated with ICH, sICH and MCE after successful recanalization of MT, but not with favorable outcome and mortality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/jnis-2023-020336 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy.
J Neurointerv Surg
January 2025
Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Background: The contact aspiration (CA) technique is often used to perform endovascular thrombectomy (EVT) for acute ischemic stroke (AIS); however, rescue strategies are necessary if CA fails to achieve recanalization. This study investigates the outcomes of incorporating stent retriever (SR) thrombectomy in the rescue strategy following failed CA.
Methods: EVT patients with failed CA attempts were identified from a large multicenter registry and stratified by rescue technique: CA alone or incorporating SR in the rescue strategy.
Emergent Carotid Stenting During Thrombectomy in Tandem Occlusions Secondary to Dissection: A STOP-CAD Secondary Study.
Stroke
January 2025
Neurology. Universitat Autònoma de Barcelona, Univ Hosp Vall d'Hebron, SPAIN.
The optimal endovascular management of cervical carotid dissection causing tandem occlusion remains uncertain. We investigated the impact of emergent carotid stenting during endovascular treatment (EVT) for acute ischemic stroke (AIS) in patients with tandem occlusion secondary to cervical carotid artery dissection. This was a secondary analysis of patients treated with EVT for AIS due to occlusive carotid artery dissection and tandem occlusion included in the retrospective international Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study.
View Article and Find Full Text PDFThe Apparent Diffusion Coefficient Color Map for Evaluating a Large Ischemic Core.
J Neuroradiol
January 2025
Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
Introduction: Our previous work demonstrated that evaluating large ischemic cores using the apparent diffusion coefficient (ADC) could predict EVT outcomes, with the most frequent ADC (peak ADC) ≥520×10 mm/s associated with better clinical results. Since the degree of ADC reduction reflects the severity of ischemic stress, this study aimed to assess the utility of an ADC color map in visualizing this stress.
Patients And Methods: This retrospective cohort study included consecutive patients with a low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) using diffusion-weighted imaging (DWI) who underwent successful EVT recanalization between April 2014 and March 2023.
Investigation of the Feasibility and Safety of a Highly Intensive Penetration Technique for Recanalization in Severe Calcified Femoropopliteal Occlusive Lesions: A Retrospective Observational Study.
Health Sci Rep
January 2025
Department of Cardiology Saiseikai Yokohama City Eastern Hospital Kanagawa Japan.
Background And Aims: When dealing with severely calcified lesions in endovascular therapy (EVT) for lower extremity artery disease (LEAD), navigating through severely calcified chronic total occlusion (CTO) using hard-tip guidewires can be challenging. To address this issue, we employed a novel highly intensive penetration (HIP) technique. This technique involves modifying the tail of a 0.
View Article and Find Full Text PDFPost-procedural Plasma D-dimer Level May Predict Futile Recanalization in Stroke Patients with Endovascular Treatment.
J Stroke Cerebrovasc Dis
January 2025
Department of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital. Electronic address:
Objective: High D-dimer levels may increase the likelihood of unfavorable clinical outcomes in patients with acute ischemic stroke. However, the impacts of serum D-dimer levels on outcomes of reperfusion treatment in patients with acute ischemic stroke have not been evaluated. This study aims to assess a possible relationship between serum D-dimer and functional outcomes in stroke patients with endovascular treatment (EVT).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!