Details der Publikation - First pass effect as an independent predictor of functional outcomes in medium vessel occlusions

First pass effect as an independent predictor of functional outcomes in medium vessel occlusions : An analysis of an international multicenter study

INTRODUCTION: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce.

PATIENTS AND METHODS: We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale 0-2 at 3 months.

RESULTS: Eight hundred thirty-six patients with a final mTICI ⩾ 2b were included in this analysis. FPE was observed in 302 patients (36.1%). In multivariable analysis, hypertension (aOR 1.55, 95% CI 1.10-2.20) and lower baseline NIHSS score (aOR 0.95, 95% CI 0.93-0.97) were independently associated with an FPE. Good outcomes were more common in the FPE versus non-FPE group (72.8% vs 52.8%), and FPE was independently associated with favorable outcome (aOR 2.20, 95% CI 1.59-3.05). 90-day mortality and intracranial hemorrhage (ICH) were significantly lower in the FPE group, 0.43 (95% CI, 0.25-0.72) and 0.55 (95% CI, 0.39-0.77), respectively.

CONCLUSION: Over 2/3 of patients with MeVOs and FPE in our cohort had a favorable outcome at 90 days. FPE is independently associated with favorable outcomes, it may reduce the risk of any intracranial hemorrhage, and 3-month mortality.

Medienart:	E-Artikel

Erscheinungsjahr:	2024
Erschienen:	2024

Enthalten in:	Zur Gesamtaufnahme - volume:9
Enthalten in:	European stroke journal - 9(2024), 1 vom: 01. März, Seite 114-123

Sprache:	Englisch

Beteiligte Personen:	Radu, Răzvan Alexandru [VerfasserIn] Costalat, Vincent [VerfasserIn] Fahed, Robert [VerfasserIn] Ghozy, Sherief [VerfasserIn] Siegler, James E [VerfasserIn] Shaikh, Hamza [VerfasserIn] Khalife, Jane [VerfasserIn] Abdalkader, Mohamad [VerfasserIn] Klein, Piers [VerfasserIn] Nguyen, Thanh N [VerfasserIn] Heit, Jeremy J [VerfasserIn] Sweid, Ahmad [VerfasserIn] El Naamani, Kareem [VerfasserIn] Regenhardt, Robert W [VerfasserIn] Diestro, Jose Danilo Bengzon [VerfasserIn] Cancelliere, Nicole M [VerfasserIn] Amllay, Abdelaziz [VerfasserIn] Meyer, Lukas [VerfasserIn] Dusart, Anne [VerfasserIn] Bellante, Flavio [VerfasserIn] Forestier, Géraud [VerfasserIn] Rouchaud, Aymeric [VerfasserIn] Saleme, Suzana [VerfasserIn] Mounayer, Charbel [VerfasserIn] Fiehler, Jens [VerfasserIn] Kühn, Anna Luisa [VerfasserIn] Puri, Ajit S [VerfasserIn] Dyzmann, Christian [VerfasserIn] Kan, Peter T [VerfasserIn] Colasurdo, Marco [VerfasserIn] Marnat, Gaultier [VerfasserIn] Berge, Jérôme [VerfasserIn] Barreau, Xavier [VerfasserIn] Sibon, Igor [VerfasserIn] Nedelcu, Simona [VerfasserIn] Henninger, Nils [VerfasserIn] Kyheng, Maéva [VerfasserIn] Marotta, Thomas R [VerfasserIn] Stapleton, Christopher J [VerfasserIn] Rabinov, James D [VerfasserIn] Ota, Takahiro [VerfasserIn] Dofuku, Shogo [VerfasserIn] Yeo, Leonard Ll [VerfasserIn] Tan, Benjamin Yq [VerfasserIn] Martinez-Gutierrez, Juan Carlos [VerfasserIn] Salazar-Marioni, Sergio [VerfasserIn] Sheth, Sunil [VerfasserIn] Renieri, Leonardo [VerfasserIn] Capirossi, Carolina [VerfasserIn] Mowla, Ashkan [VerfasserIn] Tjoumakaris, Stavropoula I [VerfasserIn] Jabbour, Pascal [VerfasserIn] Khandelwal, Priyank [VerfasserIn] Biswas, Arundhati [VerfasserIn] Clarençon, Frédéric [VerfasserIn] Elhorany, Mahmoud [VerfasserIn] Premat, Kevin [VerfasserIn] Valente, Iacopo [VerfasserIn] Pedicelli, Alessandro [VerfasserIn] Pedro Filipe, João [VerfasserIn] Varela, Ricardo [VerfasserIn] Quintero-Consuegra, Miguel [VerfasserIn] Gonzalez, Nestor R [VerfasserIn] Möhlenbruch, Markus A [VerfasserIn] Jesser, Jessica [VerfasserIn] Tancredi, Illario [VerfasserIn] Ter Schiphorst, Adrien [VerfasserIn] Yedavalli, Vivek [VerfasserIn] Harker, Pablo [VerfasserIn] Chervak, Lina M [VerfasserIn] Aziz, Yasmin [VerfasserIn] Gory, Benjamin [VerfasserIn] Paul Stracke, Christian [VerfasserIn] Hecker, Constantin [VerfasserIn] Killer-Oberpfalzer, Monika [VerfasserIn] Griessenauer, Christoph J [VerfasserIn] Thomas, Ajith J [VerfasserIn] Hsieh, Cheng-Yang [VerfasserIn] Liebeskind, David S [VerfasserIn] Alexandre, Andrea M [VerfasserIn] Faizy, Tobias D [VerfasserIn] Weyland, Charlotte [VerfasserIn] Patel, Aman B [VerfasserIn] Pereira, Vitor Mendes [VerfasserIn] Lubicz, Boris [VerfasserIn] Dmytriw, Adam A [VerfasserIn] Guenego, Adrien [VerfasserIn]

Links:	Volltext

Themen:	Journal Article MeVO Multicenter Study Outcomes research Reperfusion Stroke Thrombectomy

Anmerkungen:	Date Completed 06.03.2024 Date Revised 08.03.2024 published: Print-Electronic Citation Status MEDLINE

doi:	10.1177/23969873231208276

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM363773150

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520			\|a INTRODUCTION: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce
520			\|a PATIENTS AND METHODS: We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale 0-2 at 3 months
520			\|a RESULTS: Eight hundred thirty-six patients with a final mTICI ⩾ 2b were included in this analysis. FPE was observed in 302 patients (36.1%). In multivariable analysis, hypertension (aOR 1.55, 95% CI 1.10-2.20) and lower baseline NIHSS score (aOR 0.95, 95% CI 0.93-0.97) were independently associated with an FPE. Good outcomes were more common in the FPE versus non-FPE group (72.8% vs 52.8%), and FPE was independently associated with favorable outcome (aOR 2.20, 95% CI 1.59-3.05). 90-day mortality and intracranial hemorrhage (ICH) were significantly lower in the FPE group, 0.43 (95% CI, 0.25-0.72) and 0.55 (95% CI, 0.39-0.77), respectively
520			\|a CONCLUSION: Over 2/3 of patients with MeVOs and FPE in our cohort had a favorable outcome at 90 days. FPE is independently associated with favorable outcomes, it may reduce the risk of any intracranial hemorrhage, and 3-month mortality
650		4	\|a Multicenter Study
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700	1		\|a Kan, Peter T \|e verfasserin \|4 aut
700	1		\|a Colasurdo, Marco \|e verfasserin \|4 aut
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700	1		\|a Capirossi, Carolina \|e verfasserin \|4 aut
700	1		\|a Mowla, Ashkan \|e verfasserin \|4 aut
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700	1		\|a Jabbour, Pascal \|e verfasserin \|4 aut
700	1		\|a Khandelwal, Priyank \|e verfasserin \|4 aut
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700	1		\|a Valente, Iacopo \|e verfasserin \|4 aut
700	1		\|a Pedicelli, Alessandro \|e verfasserin \|4 aut
700	1		\|a Pedro Filipe, João \|e verfasserin \|4 aut
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700	1		\|a Hsieh, Cheng-Yang \|e verfasserin \|4 aut
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700	1		\|a Patel, Aman B \|e verfasserin \|4 aut
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700	1		\|a Dmytriw, Adam A \|e verfasserin \|4 aut
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First pass effect as an independent predictor of functional outcomes in medium vessel occlusions : An analysis of an international multicenter study

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