Literature DB >> 29802163

Redefining 'success': a systematic review and meta-analysis comparing outcomes between incomplete and complete revascularization.

Asim Rizvi1, Seyed Mohammad Seyedsaadat1, Mohammad Hassan Murad2, Waleed Brinjikji1,3, Sean T Fitzgerald1, Ramanathan Kadirvel1, Alejandro A Rabinstein4, David F Kallmes1.   

Abstract

BACKGROUND: Conventionally, 'successful' endovascular thrombectomy (EVT) had been defined as achieving revascularization of thrombolysis in cerebral infarction (TICI)-2B or greater, rather than as 'complete' (TICI-3) versus 'incomplete' (TICI-2B) revascularization.
PURPOSE: We performed a systematic review and meta-analysis of studies comparing clinical outcomes between patients with TICI-2B and TICI-3 revascularization.
METHODS: Multiple databases were searched for relevant publications between January 2003 and March 2018. Studies comparing outcomes between the TICI-2B and the TICI-3 group of acute ischemic stroke (AIS) patients treated with EVT were included. Random effects meta-analysis was performed to evaluate outcomes among TICI-2B and TICI-3 groups. The following outcomes were assessed: good neurologic outcome (modified Rankin Scale (mRS)≤2 at day 90), mortality, and intracerebral hemorrhage (ICH).
RESULTS: Twenty-one studies comprising 2747 patients were identified. Patients with TICI-2B revascularization had mRS≤2 at day 90 rates of 46% (391/847) compared with 66% (522/791) for TICI-3 patients (OR 0.46, 95% CI 0.37 to 0.57). Mortality rates were significantly higher in the TICI-2B group (78/570, 14%) than in the TICI-3 group (55/709, 8%) (OR 2.00, 95% CI 1.38 to 2.91). The ICH rates were also significantly higher in the TICI-2B group as compared with the TICI-3 group (31% [134/439] vs. 22% [108/490]; OR 2.20, 95% CI 1.47 to 3.30).
CONCLUSIONS: Differences in all major outcome measures were markedly better in patients with complete versus incomplete but still 'successful' revascularization using prior thresholds, with ORs in the order of those seen in recent definitive trials comparing EVT to an intravenous tissue plasminogen activator. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Entities:  

Keywords:  stroke; thrombectomy; thrombolysis

Mesh：

Substances：

Year:  2018        PMID： 29802163     DOI： 10.1136/neurintsurg-2018-013950

Source DB:  PubMed          Journal:  J Neurointerv Surg        ISSN： 1759-8478            Impact factor:   5.836


  15 in total

Review 1.  Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review.

Authors:  Waleed Brinjikji; Sharon Duffy; Anthony Burrows; Werner Hacke; David Liebeskind; Charles B L M Majoie; Diederik W J Dippel; Adnan H Siddiqui; Pooja Khatri; Blaise Baxter; Raul Nogeuira; Matt Gounis; Tudor Jovin; David F Kallmes
Journal:  J Neurointerv Surg       Date:  2016-05-10       Impact factor: 5.836

2.  Safety and Efficacy of Intra-arterial Urokinase After Failed, Unsuccessful, or Incomplete Mechanical Thrombectomy in Anterior Circulation Large-Vessel Occlusion Stroke.

Authors:  Johannes Kaesmacher; Sebastian Bellwald; Tomas Dobrocky; Thomas R Meinel; Eike I Piechowiak; Martina Goeldlin; Christoph C Kurmann; Mirjam R Heldner; Simon Jung; Pasquale Mordasini; Marcel Arnold; Pascal J Mosimann; Gerhard Schroth; Heinrich P Mattle; Jan Gralla; Urs Fischer
Journal:  JAMA Neurol       Date:  2020-03-01       Impact factor: 18.302

3.  Characterizing reasons for stroke thrombectomy ineligibility among potential candidates transferred in a hub-and-spoke network.

Authors:  Robert W Regenhardt; Amine Awad; Andrew W Kraft; Joseph A Rosenthal; Adam A Dmytriw; Justin E Vranic; Anna K Bonkhoff; Martin Bretzner; Mark R Etherton; Joshua A Hirsch; James D Rabinov; Aneesh B Singhal; Natalia S Rost; Christopher J Stapleton; Thabele M Leslie-Mazwi; Aman B Patel
Journal:  Stroke Vasc Interv Neurol       Date:  2022-05-20

Review 4.  Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome.

Authors:  Seán Fitzgerald; Oana M Mereuta; Karen M Doyle; Daying Dai; Ramanathan Kadirvel; David F Kallmes; Waleed Brinjikji
Journal:  J Neurosurg Sci       Date:  2018-12-05       Impact factor: 2.279

5.  Sex-specific differences in presentations and determinants of outcomes after endovascular thrombectomy for large vessel occlusion stroke.

Authors:  Robert W Regenhardt; Ashby C Turner; Joshua A Hirsch; Michael J Young; Naif M Alotaibi; Christopher J Stapleton; Aman B Patel; Thabele M Leslie-Mazwi; Natalia S Rost; Mark R Etherton
Journal:  J Neurol       Date:  2021-05-29       Impact factor: 4.849

6.  Effect of Balloon Guide Catheter Utilization on the Incidence of Sub-angiographic Peripheral Emboli on High-Resolution DWI After Thrombectomy: A Prospective Observational Study.

Authors:  Michael H Schönfeld; Reza Kabiri; Helge C Kniep; Lukas Meyer; Rosalie McDonough; Jan Sedlacik; Marielle Ernst; Gabriel Broocks; Tobias Faizy; Gerhard Schön; Bastian Cheng; Götz Thomalla; Jens Fiehler; Uta Hanning
Journal:  Front Neurol       Date:  2020-05-07       Impact factor: 4.003

7.  Mechanical Thrombectomy in Ischemic Stroke Patients With Alberta Stroke Program Early Computed Tomography Score 0-5.

Authors:  Johannes Kaesmacher; Panagiotis Chaloulos-Iakovidis; Leonidas Panos; Pasquale Mordasini; Patrik Michel; Steven D Hajdu; Marc Ribo; Manuel Requena; Christian Maegerlein; Benjamin Friedrich; Vincent Costalat; Amel Benali; Laurent Pierot; Matthias Gawlitza; Joanna Schaafsma; Vitor Mendes Pereira; Jan Gralla; Urs Fischer
Journal:  Stroke       Date:  2019-04       Impact factor: 7.914

8.  Sub-angiographic peripheral emboli in high resolution DWI after endovascular recanalization.

Authors:  Michael H Schönfeld; Reza Kabiri; Helge C Kniep; Lukas Meyer; Jan Sedlacik; Marielle Ernst; Gabriel Broocks; Tobias D Faizy; Bastian Cheng; Götz Thomalla; Jens Fiehler; Uta Hanning
Journal:  J Neurol       Date:  2020-01-29       Impact factor: 4.849

9.  Mechanical thrombectomy for basilar artery occlusion: efficacy, outcomes, and futile recanalization in comparison with the anterior circulation.

Authors:  Thomas Raphael Meinel; Johannes Kaesmacher; Jan Gralla; Urs Fischer; Panagiotis Chaloulos-Iakovidis; Leonidas Panos; Pasquale Mordasini; Pascal J Mosimann; Patrik Michel; Steven Hajdu; Marc Ribo; Manuel Requena; Christian Maegerlein; Benjamin Friedrich; Vincent Costalat; Amel Benali; Laurent Pierot; Matthias Gawlitza; Joanna Schaafsma; Vitor M Pereira
Journal:  J Neurointerv Surg       Date:  2019-06-25       Impact factor: 5.836

10.  Futile complete recanalization: patients characteristics and its time course.

Authors:  Takaya Kitano; Kenichi Todo; Shinichi Yoshimura; Kazutaka Uchida; Hiroshi Yamagami; Nobuyuki Sakai; Manabu Sakaguchi; Hajime Nakamura; Haruhiko Kishima; Hideki Mochizuki; Masayuki Ezura; Yasushi Okada; Kazuo Kitagawa; Kazumi Kimura; Makoto Sasaki; Norio Tanahashi; Kazunori Toyoda; Eisuke Furui; Yuji Matsumaru; Kazuo Minematsu; Takeshi Morimoto
Journal:  Sci Rep       Date:  2020-03-18       Impact factor: 4.379
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