Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Refractory Stroke Thrombectomy: Prevalence, Etiology, and Adjunctive Treatment in a North American Cohort

Refractory Stroke Thrombectomy: Prevalence, Etiology, and Adjunctive Treatment in a North... Published April 22, 2021 as 10.3174/ajnr.A7124 ORIGINAL RESEARCH INTERVENTIONAL Refractory Stroke Thrombectomy: Prevalence, Etiology, and Adjunctive Treatment ina NorthAmericanCohort R.N. Abdalla, D.R. Cantrell, A. Shaibani, M.C. Hurley, B.S. Jahromi, M.B. Potts, and S.A. Ansari ABSTRACT BACKGROUND AND PURPOSE: Acute stroke intervention refractory to mechanical thrombectomy may be due to underlying vessel wall pathology including intracranial atherosclerotic disease and intracranial arterial dissection or recalcitrant emboli. We studied the prevalence and etiology of refractory thrombectomy, the safety and efficacy of adjunctive interventions in a North American–based cohort. MATERIALS AND METHODS: We performed a multicenter, retrospective study of refractory thrombectomy, defined as unsuccess- ful recanalization, vessel reocclusion in ,72 hours, or required adjunctive antiplatelet glycoprotein IIb/IIIa inhibitors, intracranial angioplasty and/or stenting to achieve and maintain reperfusion. Clinical and imaging criteria differentiated etiologies for refractory thrombectomy. Baseline demographics, cerebrovascular risk factors, technical/clinical outcomes, and procedural safety/complica- tions were compared between refractory and standard thrombectomy groups. Multivariable logistic regression analysis was per- formed to determine independent predictors of refractory thrombectomy. RESULTS: Refractory thrombectomy was identified in 25/302 cases (8.3%), correlated with diabetes (44% versus 22%, P¼ .02) as an inde- pendent predictor with OR ¼ 2.72 (95% CI, 1.05–7.09; P¼ .04) and inversely correlated http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Refractory Stroke Thrombectomy: Prevalence, Etiology, and Adjunctive Treatment in a North American Cohort

Loading next page...
 
/lp/american-journal-of-neuroradiology/refractory-stroke-thrombectomy-prevalence-etiology-and-adjunctive-DWx8BH1ik6
Publisher
American Journal of Neuroradiology
Copyright
© 2021 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A7124
Publisher site
See Article on Publisher Site

Abstract

Published April 22, 2021 as 10.3174/ajnr.A7124 ORIGINAL RESEARCH INTERVENTIONAL Refractory Stroke Thrombectomy: Prevalence, Etiology, and Adjunctive Treatment ina NorthAmericanCohort R.N. Abdalla, D.R. Cantrell, A. Shaibani, M.C. Hurley, B.S. Jahromi, M.B. Potts, and S.A. Ansari ABSTRACT BACKGROUND AND PURPOSE: Acute stroke intervention refractory to mechanical thrombectomy may be due to underlying vessel wall pathology including intracranial atherosclerotic disease and intracranial arterial dissection or recalcitrant emboli. We studied the prevalence and etiology of refractory thrombectomy, the safety and efficacy of adjunctive interventions in a North American–based cohort. MATERIALS AND METHODS: We performed a multicenter, retrospective study of refractory thrombectomy, defined as unsuccess- ful recanalization, vessel reocclusion in ,72 hours, or required adjunctive antiplatelet glycoprotein IIb/IIIa inhibitors, intracranial angioplasty and/or stenting to achieve and maintain reperfusion. Clinical and imaging criteria differentiated etiologies for refractory thrombectomy. Baseline demographics, cerebrovascular risk factors, technical/clinical outcomes, and procedural safety/complica- tions were compared between refractory and standard thrombectomy groups. Multivariable logistic regression analysis was per- formed to determine independent predictors of refractory thrombectomy. RESULTS: Refractory thrombectomy was identified in 25/302 cases (8.3%), correlated with diabetes (44% versus 22%, P¼ .02) as an inde- pendent predictor with OR ¼ 2.72 (95% CI, 1.05–7.09; P¼ .04) and inversely correlated

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Apr 22, 2021

References