D Yang1, Y Hao2,3, W Zi4, H Wang1,5, D Zheng6, H Li7, M Tu8, Y Wan9, P Jin10, G Xiao11, Y Xiong4, G Xu12,4, X Liu13,2,4. 1. From the Department of Neurology (D.Y., H.W., X.L.), Jinling Hospital, Second Military Medical University, Nanjing, Jiangsu Province, China. 2. Department of Neurology (Y.H., G.Xu, X.L.), Jinling Hospital, Southern Medical University, Nanjing, Jiangsu Province, China. 3. Department of Emergency Medicine (Y.H.), First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. 4. Department of Neurology (W.Z., Y.X., G.Xu, X.L.), Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. 5. Department of Neurology (H.W.), 89th Hospital of the People's Liberation Army, Weifang, Shandong Province, China. 6. Department of Neurology (D.Z.), 175th Hospital of the People's Liberation Army, Affiliated Southeast Hospital of Xiamen University, Zhangzhou, Fujian Province, China. 7. Department of Neurology (H.L.), 476th Hospital of the People's Liberation Army, Fuzhou, Fujian Province, China. 8. Department of Neurology (M.T.), Hubei Wuchang Hospital, Wuhan, Hubei Province, China. 9. Department of Neurology (Y.W.), Hubei Zhongshan Hospital, Wuhan, Hubei Province, China. 10. Department of Neurology (P.J.), Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, Anhui Province, China. 11. Department of Neurology (G.Xiao), Second Affiliated Hospital of Soochow University; Suzhou, Jiangsu Province, China. 12. Department of Neurology (Y.H., G.Xu, X.L.), Jinling Hospital, Southern Medical University, Nanjing, Jiangsu Province, China gelinxu@nju.edu.cn xfliu2@vip.163.com. 13. From the Department of Neurology (D.Y., H.W., X.L.), Jinling Hospital, Second Military Medical University, Nanjing, Jiangsu Province, China gelinxu@nju.edu.cn xfliu2@vip.163.com.
Abstract
BACKGROUND AND PURPOSE: In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes. MATERIALS AND METHODS: Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device. We matched patients treated with the 2 stent sizes using propensity score analysis. The successful outcome was reperfusion as measured by the modified Thrombolysis in Cerebral Infarction score immediately postprocedure and the dichotomized modified Rankin Scale score at 90 days. Symptomatic intracerebral hemorrhage and in-hospital mortality were also recorded. RESULTS: After propensity score analysis, group outcomes did not differ. In addition, in patients with atherosclerosis-related occlusion, a higher reperfusion rate (P = .021) was observed in the Solitaire 4 group, as well as a shorter time interval (P = .002) and fewer passes (P = .025). Independent predictors of successful reperfusion in patients with atherosclerotic disease on logistic analysis were the small stent (OR, 3.217; 95% CI, 1.129-9.162; P = .029) and the propensity score acting as a covariate (OR, 52.84; 95% CI, 3.468-805.018; P = .004). CONCLUSIONS: We found no evidence of a differential effect of intra-arterial therapy based on the size of Solitaire retrievers. In patients with atherosclerotic disease, favorable reperfusion was associated with deployment of a small stent.
BACKGROUND AND PURPOSE: In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes. MATERIALS AND METHODS: Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device. We matched patients treated with the 2 stent sizes using propensity score analysis. The successful outcome was reperfusion as measured by the modified Thrombolysis in Cerebral Infarction score immediately postprocedure and the dichotomized modified Rankin Scale score at 90 days. Symptomatic intracerebral hemorrhage and in-hospital mortality were also recorded. RESULTS: After propensity score analysis, group outcomes did not differ. In addition, in patients with atherosclerosis-related occlusion, a higher reperfusion rate (P = .021) was observed in the Solitaire 4 group, as well as a shorter time interval (P = .002) and fewer passes (P = .025). Independent predictors of successful reperfusion in patients with atherosclerotic disease on logistic analysis were the small stent (OR, 3.217; 95% CI, 1.129-9.162; P = .029) and the propensity score acting as a covariate (OR, 52.84; 95% CI, 3.468-805.018; P = .004). CONCLUSIONS: We found no evidence of a differential effect of intra-arterial therapy based on the size of Solitaire retrievers. In patients with atherosclerotic disease, favorable reperfusion was associated with deployment of a small stent.
Authors: N F Belachew; T Dobrocky; T R Meinel; A Hakim; J Vynckier; M Arnold; D J Seiffge; R Wiest; E I Piechowiak; U Fischer; J Gralla; P Mordasini; J Kaesmacher Journal: AJNR Am J Neuroradiol Date: 2021-10-14 Impact factor: 3.825
Authors: David Hernández; Elena Serrano; Gemma Molins; Federico Zarco; Oscar Chirife; Mariano Werner; Blanca Lara; Anna Ramos; Laura Llull; Manuel Requena; Marta de Dios Las Cuevas; Sebastián Remollo; Carlos Piñana; Antonio López-Rueda Journal: Front Neurol Date: 2022-06-30 Impact factor: 4.086
Authors: Carmen Serna Candel; Marta Aguilar Pérez; Hansjörg Bäzner; Hans Henkes; Victoria Hellstern Journal: Front Neurol Date: 2021-06-22 Impact factor: 4.003