Relationship of thrombus length to number of stent retrievals, revascularization, and outcomes in acute ischemic stroke.

Abstract

PURPOSE:

To study the relationship between intracranial thrombus length and number of stent retrievals, revascularization rates, and functional outcomes in stroke.

MATERIALS AND METHODS:

Retrospective data were collected from consecutive cases of stroke treated with endovascular procedures at a single institution from April 2012-September 2013. Thrombus length was measured in the anterior cerebral circulation. Demographic and clinical details; involved vessels; and procedural details, including the number of devices used and number of retrievals used for each device, were recorded. Revascularization rates and 90-day functional outcomes were recorded.

RESULTS:

Data regarding the length of thrombus in the anterior cerebral circulation were available for 28 patients. There was no significant association between thrombus length and number of stent retrievals (P = .3780), final thrombolysis in cerebral infarction (TICI) score (P = .4835), or 90-day modified Rankin Scale score (P = .4146). There was a significant difference (P = .0280) between number of retrievals and final TICI score, with lower number of retrieval passes corresponding to higher final TICI scores.

CONCLUSIONS:

The data suggest no relationship between thrombus length and number of stent retrievals, final TICI score, or functional neurologic outcomes at 90 days in stent retrieval thrombectomy for acute ischemic stroke. These results do not support a predictive value for thrombus length quantification in the evaluation of stroke.

• Authors: Gaurav Jindal, Timothy Miller, Ravi Shivashankar, Jason Mitchell, Barney J Stern, Karen Yarbrough, Dheeraj Gandhi
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 25 Issue 10 Pg. 1549-57 (Oct 2014) ISSN: 1535-7732 [Electronic] United States
• PMID: 24999164 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiography, Digital Subtraction
• Baltimore
• Brain Ischemia (diagnosis, physiopathology, therapy)
• Cerebral Angiography (methods)
• Device Removal
• Diffusion Magnetic Resonance Imaging
• Disability Evaluation
• Endovascular Procedures (adverse effects, instrumentation)
• Female
• Humans
• Intracranial Thrombosis (diagnosis, physiopathology, therapy)
• Magnetic Resonance Angiography
• Male
• Middle Aged
• Predictive Value of Tests
• Recovery of Function
• Retrospective Studies
• Risk Factors
• Stents
• Stroke (diagnosis, physiopathology, therapy)
• Thrombectomy (adverse effects)
• Time Factors
• Treatment Outcome