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Impact of temporary opening using a stent retriever on clinical outcome in acute ischemic stroke

Authors
 Dongbeom Song  ;  Ji Hoe Heo  ;  Dong Ik Kim  ;  Dong Joon Kim  ;  Byung Moon Kim  ;  Kijeong Lee  ;  Joonsang Yoo  ;  Hye Sun Lee  ;  Hyo Suk Nam  ;  Young Dae Kim 
Citation
 PLoS One, Vol.10(4) : e0124551, 2015 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2015
Abstract
BACKGROUND: Stent retriever has a distinct ability to restore blood flow temporarily before achieving final reperfusion. There has been a limited report regarding the clinical impact of it. We investigated if temporary opening of occluded vessels using a stent retriever before final reperfusion might improve clinical outcome in acute ischemic stroke patients who received the endovascular reperfusion treatment. METHODS: We enrolled consecutive ischemic stroke patients who had an initial occlusive lesion in the anterior circulation and achieved final reperfusion (Thrombolysis In Cerebral Infarction [TICI] ≥2) by endovascular treatment. Temporary opening was defined as the presence of ante grade flow (TICI≥2) during deployment of a stent retriever. Favorable outcome was defined as a modified Rankin scale score≤2 at 90 day. RESULTS: A total of 98 patients were included in the study and temporary opening was achieved in 49 (50%). Temporary opening was associated with favorable outcome (odds ratio, 7.825; 95% confidence interval, 1.592-38.461; p = 0.011) in the multivariate analysis. The probability of having a favorable outcome tended to decrease as time from onset to final reperfusion increased in patients without temporary opening. However, this trend was not evident in the patient with temporary opening. The beneficial effect of temporary opening on clinical outcome seemed to be present in patients with good collaterals but not in patients with poor collaterals. CONCLUSIONS: Temporary opening of occluded vessel using a stent retriever may be beneficial for improving clinical outcome in acute ischemic stroke patients.
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DOI
10.1371/journal.pone.0124551
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김동익(Kim, Dong Ik)
김동준(Kim, Dong Joon) ORCID logo https://orcid.org/0000-0002-7035-087X
김병문(Kim, Byung Moon) ORCID logo https://orcid.org/0000-0001-8593-6841
김영대(Kim, Young Dae)
남효석(Nam, Hyo Suk) ORCID logo https://orcid.org/0000-0002-4415-3995
송동범(Song, Dong Beom)
유준상(Yoo, Joon Sang)
이기정(Lee, Ki Jeong)
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139928
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