Effect of incomplete reperfusion patterns on clinical outcome: insights from the ESCAPE-NA1 trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F24%3A00079171" target="_blank" >RIV/00159816:_____/24:00079171 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/24:00135493

Result on the web

<a href="https://jnis.bmj.com/content/early/2023/07/25/jnis-2023-020553" target="_blank" >https://jnis.bmj.com/content/early/2023/07/25/jnis-2023-020553</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1136/jnis-2023-020553" target="_blank" >10.1136/jnis-2023-020553</a>

Result language

angličtina

Original language name

Effect of incomplete reperfusion patterns on clinical outcome: insights from the ESCAPE-NA1 trial

Original language description

BackgroundIncomplete reperfusion (IR) after mechanical thrombectomy (MT) can be a consequence of residual occlusion, no-reflow phenomenon, or collateral counterpressure. Data on the impact of these phenomena on clinical outcome are limited. MethodsPatients from the ESCAPE-NA1 trial with IR (expanded Thrombolysis In Cerebral Infarction (eTICI) 2b) were compared with those with complete or near-complete reperfusion (eTICI 2c-3) on the final angiography run. Final runs were assessed for (a) an MT-accessible occlusion, or (b) a non-MT-accessible occlusion pattern. The primary clinical outcome was modified Rankin Scale (mRS) 0-2 at 90 days. Our imaging outcome was infarction in IR territory on follow-up imaging. Unadjusted and adjusted incidence rate ratios (aIRR) with 95% confidence intervals (95% CI) were obtained. ResultsOf 1105 patients, 443 (40.1%) with IR and 506 (46.1%) with complete or near-complete reperfusion were included. An MT-accessible occlusion was identified in 147/443 patients (33.2%) and a non-MT-accessible occlusion in 296/443 (66.8%). As compared with patients with near-complete/complete reperfusion, patients with IR had significantly lower chances of achieving mRS 0-2 at 90 days (aIRR 0.82, 95% CI 0.74 to 0.91). Rates of mRS 0-2 were lower in the MT-accessible occlusion group as compared with the non-MT-accessible occlusion pattern group (aIRR 0.71, 95% CI 0.60 to 0.83, and aIRR 0.89, 95% CI 0.81 to 0.98, respectively). More patients with MT-accessible occlusion patterns developed infarcts in the non-reperfused territory as compared with patients with non-MT occlusion patterns (68.7% vs 46.3%). ConclusionIR was associated with worse clinical outcomes than near-complete/complete reperfusion. Two-thirds of our patients with IR had non-MT-accessible occlusion patterns which were associated with better clinical and imaging outcomes compared with those with MT-accessible occlusion patterns.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30230 - Other clinical medicine subjects

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of NeuroInterventional Surgery

ISSN

1759-8478

e-ISSN

1759-8486

Volume of the periodical

16

Issue of the periodical within the volume

8

Country of publishing house

GB - UNITED KINGDOM

Number of pages

7

Pages from-to

809-814

UT code for WoS article

001035982000001

EID of the result in the Scopus database

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