Effect of first pass reperfusion on outcome in patients with posterior circulation ischemic stroke. (4th May 2021)

• Record Type: Journal Article
• Authors: den Hartog, Sanne J; Roozenbeek, Bob; Boodt, Nikki; Bruggeman, Agnetha A E; van Es, Adriaan C G M; Emmer, Bart J; Majoie, Charles B L M; van den Wijngaard, Ido R; van Doormaal, Pieter Jan; van Zwam, Wim H; Lingsma, Hester F; Dippel, Diederik W J
• Other Names: author non-byline.; Dippel Diederik author non-byline.; van der Lugt Aad author non-byline.; Majoie Charles author non-byline.; Roos Yvo author non-byline.; van Oostenbrugge Robert author non-byline.; van Zwam Wim author non-byline.; Boiten Jelis author non-byline.; Vos Jan Albert author non-byline.; Jansen Ivo author non-byline.; Mulder Maxim author non-byline.; Goldhoorn Robert- Jan author non-byline.; Compagne Kars author non-byline.; Kappelhof Manon author non-byline.; Brouwer Josje author non-byline.; den Hartog Sanne author non-byline.; Hinsenveld Wouter author non-byline.; Dippel Diederik author non-byline.; Roozenbeek Bob author non-byline.; van der Lugt Aad author non-byline.; Majoie Charles author non-byline.; Roos Yvo author non-byline.; Emmer Bart author non-byline.; Coutinho Jonathan author non-byline.; Schonewille Wouter author non-byline.; Vos Jan Albert author non-byline.; Wermer Marieke author non-byline.; Walderveen Marianne van author non-byline.; van Es Adriaan author non-byline.; Staals Julie author non-byline.; Oostenbrugge Robert van author non-byline.; Zwam Wim van author non-byline.; Hofmeijer Jeannette author non-byline.; Martens Jasper author non-byline.; Lycklama à Nijeholt Geert author non-byline.; Boiten Jelis author non-byline.; de Bruijn Sebastiaan author non-byline.; van Dijk Lukas author non-byline.; van der Worp Bart author non-byline.; Lo Rob author non-byline.; van Dijk Ewoud author non-byline.; Boogaarts Hieronymus author non-byline.; de Vries J author non-byline.; de Kort Paul author non-byline.; van Tuijl Julia author non-byline.; Peluso Jo author non-byline.; Fransen Puck author non-byline.; van den Berg Jan author non-byline.; Hasselt Boudewijn van author non-byline.; Aerden Leo author non-byline.; Dallinga René author non-byline.; Uyttenboogaart Maarten author non-byline.; Eschgi Omid author non-byline.; Bokkers Reinoud author non-byline.; Schreuder Tobien author non-byline.; Heijboer Roel author non-byline.; Keizer Koos author non-byline.; Yo Lonneke author non-byline.; den Hertog Heleen author non-byline.; Sturm Emiel author non-byline.; Brouwers Paul author non-byline.; Majoie Charles author non-byline.; van Zwam Wim author non-byline.; van der Lugt Aad author non-byline.; Lycklama à Nijeholt Geert author non-byline.; van Walderveen Marianne author non-byline.; Sprengers Marieke author non-byline.; Jenniskens Sjoerd author non-byline.; van den Berg René author non-byline.; Yoo Albert author non-byline.; Beenen Ludo author non-byline.; Postma Alida author non-byline.; Roosendaal Stefan author non-byline.; van der Kallen Bas author non-byline.; van den Wijngaard Ido author non-byline.; van Es Adriaan author non-byline.; Emmer Bart author non-byline.; Martens Jasper author non-byline.; Yo Lonneke author non-byline.; Vos Jan Albert author non-byline.; Bot Joost author non-byline.; van Doormaal Pieter Jan author non-byline.; Meijer Anton author non-byline.; Ghariq Elyas author non-byline.; Bokkers Reinoud author non-byline.; Proosdij Marc author non-byline.; Krietemeijer G Menno author non-byline.; Peluso Jo author non-byline.; Boogaarts Hieronymus author non-byline.; Gerrits Dick author non-byline.; Dinkelaar Wouter author non-byline.; Appelman Auke author non-byline.; Hammer Bas author non-byline.; Pegge Sjoert author non-byline.; van der Hoorn Anouk author non-byline.; Vinke Saman author non-byline.; Cornelissen Sandra author non-byline.; van der Leij Christiaan author non-byline.; Brans Rutger author non-byline.; Dippel Diederik author non-byline.; van der Lugt Aad author non-byline.; Majoie Charles author non-byline.; Roos Yvo author non-byline.; Oostenbrugge Robert van author non-byline.; Zwam Wim van author non-byline.; Lycklama à Nijeholt Geert author non-byline.; Boiten Jelis author non-byline.; Vos Jan Albert author non-byline.; Schonewille Wouter author non-byline.; Hofmeijer Jeannette author non-byline.; Martens Jasper author non-byline.; van der Worp Bart author non-byline.; Lo Rob author non-byline.; van Oostenbrugge Robert author non-byline.; Hofmeijer Jeannette author non-byline.; Zwenneke Flach H author non-byline.; Lingsma Hester author non-byline.; el Ghannouti Naziha author non-byline.; Sterrenberg Martin author non-byline.; Pellikaan Wilma author non-byline.; Sprengers Rita author non-byline.; Elfrink Marjan author non-byline.; Simons Michelle author non-byline.; Vossers Marjolein author non-byline.; de Meris Joke author non-byline.; Vermeulen Tamara author non-byline.; Geerlings Annet author non-byline.; van Vemde Gina author non-byline.; Simons Tiny author non-byline.; Messchendorp Gert author non-byline.; Nicolaij Nynke author non-byline.; Bongenaar Hester author non-byline.; Bodde Karin author non-byline.; Kleijn Sandra author non-byline.; Lodico Jasmijn author non-byline.; Droste Hanneke author non-byline.; Wollaert Maureen author non-byline.; Verheesen Sabrina author non-byline.; Jeurrissen D author non-byline.; Bos Erna author non-byline.; Drabbe Yvonne author non-byline.; Sandiman Michelle author non-byline.; Aaldering Nicoline author non-byline.; Zweedijk Berber author non-byline.; Vervoort Jocova author non-byline.; Ponjee Eva author non-byline.; Romviel Sharon author non-byline.; Kanselaar Karin author non-byline.; Barning Denn author non-byline.; Venema Esmee author non-byline.; Chalos Vicky author non-byline.; Geuskens Ralph author non-byline.; van Straaten Tim author non-byline.; Ergezen Saliha author non-byline.; Harmsma Roger author non-byline.; Muijres Daan author non-byline.; de Jong Anouk author non-byline.; Berkhemer Olvert author non-byline.; Boers Anna author non-byline.; Huguet J author non-byline.; Groot P.F.C author non-byline.; Mens Marieke author non-byline.; van Kranendonk Katinka author non-byline.; Treurniet Kilian author non-byline.; Tolhuisen Manon author non-byline.; Alves Heitor author non-byline.; Weterings Annick author non-byline.; Kirkels Eleonora author non-byline.; Voogd Eva author non-byline.; Schupp Lieve author non-byline.; Collette Sabine author non-byline.; Groot Adrien author non-byline.; LeCouffe Natalie author non-byline.; Konduri Praneeta author non-byline.; Prasetya Haryadi author non-byline.; Arrarte-Terreros Nerea author non-byline.; Ramos Lucas author non-byline.; Boodt Nikki author non-byline.; Pirson Anne author non-byline.; Bruggeman Agnetha author non-byline.; Lo Rob author non-byline.;
• Is Part Of: Journal of neurointerventional surgery. Volume 14:Number 4(2022)
• Page Start: 333
• Page End: 340
• Publication Date: 2021-05-04
• Subjects: stroke -- thrombectomy -- brain -- intervention; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2021-017507
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Background: First pass reperfusion (FPR), that is, excellent reperfusion (expanded treatment in cerebral ischemia (eTICI) 2C-3) in one pass, after endovascular treatment (EVT) of an occluded artery in the anterior circulation, is associated with favorable clinical outcome, even when compared with multiple pass excellent reperfusion (MPR). In patients with posterior circulation ischemic stroke (PCS), the same association is expected, but currently unknown. We aimed to assess characteristics associated with FPR and the influence of FPR versus MPR on outcomes in patients with PCS. Methods: We used data from the MR CLEAN Registry, a prospective observational study. The effect of FPR on 24-hour National Institutes of Health Stroke Scale (NIHSS) score, as percentage reduction, and on modified Rankin Scale (mRS) scores at 3 months, was tested with linear and ordinal logistic regression models. Results: Of 224 patients with PCS, 45 patients had FPR, 47 had MPR, and 90 had no excellent reperfusion (eTICI <2C). We did not find an association between any of the patient, imaging, or treatment characteristics and FPR. FPR was associated with better NIHSS (−45% (95% CI: −65% to −12%)) and better mRS scores (adjusted common odds ratio (acOR): 2.16 (95% CI: 1.23 to 3.79)) compared with no FPR. Outcomes after FPR were also more favorable compared with MPR, but the effect was smaller and not statistically significant (NIHSS: −14% (95% CI: −51% to 49%), mRS acOR: 1.50 (95% CI: 0.75 to 3.00)). Conclusions: FPR in patients with PCS is associated with favorable clinical outcome in comparison with no FPR. In comparison with MPR, the effect of FPR was no longer statistically significant. Nevertheless, our data support the notion that FPR should be the treatment target to pursue in every patient treated with EVT.