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Stent Opening Visualization During Mechanical Thrombectomy; Relationship with the Retrieved Clot and Procedural Success

Authors
 Ilah Shin  ;  Byung Moon Kim  ;  Dong Joon Kim 
Citation
 JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, Vol.31(1) : 106168, 2022-01 
Journal Title
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
ISSN
 1052-3057 
Issue Date
2022-01
MeSH
Humans ; Ischemic Stroke* / therapy ; Mechanical Thrombolysis* / methods ; Retrospective Studies ; Stents* ; Treatment Outcome
Keywords
Acute stroke ; Cerebral angiography ; Stent retriever ; Thrombectomy
Abstract
Purpose: The angiographic visualization of the stent during mechanical thrombectomy (MT) may provide information regarding the characteristics of the underlying occluding clot, device-clot interaction, and recanalization. The purpose of this study was to evaluate the open stent sign in relation to the retrieved clot and recanalization.

Methodology: 78 patients treated with the stent retriever for acute stroke were retrospectively reviewed. The open stent sign was defined as full opening (>80% of normal vessel diameter) of the stent on DSA after deployment across the occlusion. The retrieved clot was visually classified as red or non-red clots. The relationship between the open stent sign and the patient characteristics, recanalization, retrieved clot, and clinical outcome were analyzed.

Results: Overall successful recanalization and good outcome was achieved in 68 (87.2%) and 35 (44.9%) patients, respectively. Open stent sign was seen in 52 patients (66.7%). Occlusions showing positive open stent sign was associated with significantly higher first pass effect (44.2% vs 19.2%, p=0.044) and successful recanalization rate (94.2% vs 73.1%, p=0.013) compared to negative open stent sign. The open stent sign was associated with higher incidence of red clot (75.0% vs 38.9%, p=0.008). On multivariate analysis, the open stent sign (OR 22.721, 95% CI 1.953-264.372, p=0.013) was a predictor of successful recanalization.

Conclusions: The visualization of the open stent during MT of acute ischemic stroke may provide added information in terms of clot characteristics and procedural success. The open stent sign is associated with red clots, higher first pass effect and successful recanalization.
Full Text
https://www.sciencedirect.com/science/article/pii/S1052305721005735
DOI
10.1016/j.jstrokecerebrovasdis.2021.106168
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188088
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