AI Article Synopsis
- This study examined how the first pass effect (FPE) influences outcomes in patients with posterior circulation acute ischemic stroke (PC-AIS) who underwent endovascular treatment.
- Researchers reviewed data from 328 patients, finding that those in the FPE group had a significantly higher rate of favorable outcomes (mRS ≤ 3) compared to those who experienced multiple pass effects (MPE).
- Key factors leading to successful FPE included specific treatment methods (aspiration or combination) and certain patient characteristics, while negative factors included hypertension and the use of general anesthesia.
Article Abstract
Objective: This study aims to investigate the impact of first pass effect (FPE) on outcomes in the posterior circulation acute ischemic stroke (PC-AIS) and the independent predictors of FPE.
Methods: This was a multicenter, retrospective study. PC-AIS patients who underwent endovascular treatment were reviewed. The cohort achieving complete or nearly complete reperfusion (defined as expanded treatment in cerebralischemia [eTICI] ≥ 2c) was categorized into the FPE and multiple pass effect (MPE) groups. FPE was defined as achieving eTICI ≥ 2c with a single pass and without the use of rescue therapy. Modified FPE (mFPE) was defined as meeting the criteria for FPE but with eTICI ≥ 2b. The association of FPE with 90-day clinical outcomes and predictors for FPE were both investigated.
Results: The study included a total of 328 patients, with 69 patients (21 %) in the FPE group. For primary outcome, FPE had a significant higher favorable outcome (mRS ≤ 3) rate than MPE (65.2 % vs. 44.8 %, p = 0.003). Similar outcomes were observed in the mFPE. Furthermore, FPE was significantly associated with favorable outcome (adjusted OR 2.23, 95 % CI 1.06-4.73, p = 0.036). Positive predictors for FPE included occlusion in the distal basilar artery, the first-line aspiration or combination, and cardioembolic etiology. Negative predictors for FPE included hypertension and general anesthesia.
Conclusion: For PC-AIS patients due to large or medium vessel occlusion, FPE is associated with favorable clinical outcomes. The first-line techniques of aspiration or combination, as well as avoiding general anesthesia, contribute to a better realization of FPE.
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| http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2024.107640 | DOI Listing |
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- - Recent research indicates that the fear of positive evaluation (FPE) is significantly linked to social anxiety, but the specifics of this relationship haven’t been deeply explored.
- - Two studies were conducted: the first showed that FPE contributes to social anxiety independently of fear of negative evaluation (FNE) and negative thinking patterns.
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