ArticleClinical neuroradiology2021
Factors Associated with Failure of Reperfusion in Endovascular Therapy for Acute Ischemic Stroke : A Multicenter Analysis.
Article in Clinical neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- The Influence of Body Mass Index on Outcomes in Patients Undergoing Mechanical Thrombectomy for Anterior Circulation Large Vessel Occlusion: Institutional Experience and Meta-analysis.Neurocritical care · 2024Pooled it
- Systematic Review on Endovascular Access to Intracranial Arteries for Mechanical Thrombectomy in Acute Ischemic Stroke.Clinical neuroradiology · 2022Pooled it
- Quantitative assessment of cerebral venous outflow on routine CT angiography in acute ischemic stroke.European radiology · 2026Article
- Clinical outcomes of patients with unsuccessful mechanical thrombectomy versus best medical management of medium vessel occlusion stroke in the middle cerebral artery territory.Journal of neurointerventional surgery · 2025Article
- Endovascular Thrombectomy Technique Optimization: A SVIN Registry Analysis.Stroke (Hoboken, N.J.) · 2025Article
- A Novel Nomogram for the Early Identification of Cardioembolic Stroke Using Clinical and Dual-Energy CT Features.Reviews in cardiovascular medicine · 2025Article
- Fusion Imaging in Endovascular Thrombectomy for Acute Ischemic Stroke.Stroke (Hoboken, N.J.) · 2025Article
- Effectiveness of intravenous thrombolysis in patients with large-vessel occlusion receiving endovascular treatment in Korea.Acute and critical care · 2025Article
- Tirofiban Benefits the Outcome of Stroke Patients With Large Artery Atherosclerosis Achieving Full Reperfusion and High NIHSS Scores.European journal of neurology · 2025Review
- Mechanical thrombectomy failure in anterior and posterior circulation stroke: current results from a high-volume comprehensive center.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Article
- Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke.Journal of neurology · 2024Article
- Clinico-radiological features of intracranial atherosclerosis-related large vessel occlusion prior to endovascular treatment.Scientific reports · 2024Article
- Association Between Intravenous Thrombolysis and Clinical Outcomes Among Patients With Ischemic Stroke and Unsuccessful Mechanical Reperfusion.JAMA network open · 2023Observational
- More Retrieval Attempts are Associated with Poorer Functional Outcome After Unsuccessful Thrombectomy.Clinical neuroradiology · 2022Article
- Early TICI 2b or Late TICI 3-Is Perfect the Enemy of Good?Clinical neuroradiology · 2022Article
- Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization.Journal of clinical medicine · 2022Article
- JET 7 catheter for direct aspiration in carotid T occlusions: preliminary experience and literature review.La Radiologia medica · 2022Review
- Sex-specific differences in presentations and determinants of outcomes after endovascular thrombectomy for large vessel occlusion stroke.Journal of neurology · 2022Article
- Off-hour effect is not significant in endovascular treatment for anterior circulation large vessel occlusion in a multicentre registry.Stroke and vascular neurology · 2021Article
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimIn acute large vessel occlusions, endovascular therapy (EVT) achieves flow restoration in the majority of cases; however, EVT fails to achieve sufficient reperfusion in a substantial minority of patients. This study aimed to identify predictors of failed reperfusion.
methodsIn this study 2211 patients from the German Stroke Registry who received EVT for anterior circulation stroke were retrospectively analyzed. Failure of reperfusion was defined as thrombolysis in cerebral infarction (TICI) grades 0/1/2a, and sufficient reperfusion as TICI 2b/3. In 1629 patients with complete datasets, associations between failure of reperfusion and baseline clinical data, comorbidities, location of occlusion, and procedural data were assessed with multiple logistic regression.
resultsFailure of reperfusion occurred in 371 patients (16.8%) and was associated with the following locations of occlusion: cervical internal carotid artery (ICA, adjusted odds ratio, OR 2.01, 95% confidence interval, CI 1.08-3.69), intracranial ICA without carotid T occlusion (adjusted OR 1.79, 95% CI 1.05-2.98), and M2 segment (adjusted OR 1.86, 95% CI 1.21-2.84). Failed reperfusion was also associated with cervical ICA stenosis (>70% stenosis, adjusted OR 2.90, 95% CI 1.69-4.97), stroke of other determined etiology by TOAST (Trial of ORG 10172 in acute stroke treatment) criteria (e.g. nonatherosclerotic vasculopathies, adjusted OR 2.73, 95% CI 1.36-5.39), and treatment given outside the usual working hours (adjusted OR 1.41, 95% CI 1.07-1.86). Successful reperfusion was associated with higher Alberta stroke program early CT score (ASPECTS) on initial imaging (adjusted OR 0.85, 95% CI 0.79-0.92), treatment with the patient under general anesthesia (adjusted OR 0.72, 95% CI 0.54-0.96), and concomitant ICA stenting in patients with ICA stenosis (adjusted OR 0.20, 95% CI 0.11-0.38).
conclusionSeveral factors are associated with failure of reperfusion, most notably occlusions of the proximal ICA and low ASPECTS on admission. Conversely, stent placement in the proximal ICA was associated with reperfusion success.
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