ArticleEuropean journal of neurology2022
Mechanical thrombectomy failure in anterior circulation strokes: Outcomes and predictors of favorable outcome.
Article in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Intravenous Thrombolysis in Distal Medium Middle Cerebral Artery Occlusion Patients with Unsuccessful Mechanical Reperfusion.Clinical neuroradiology · 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
- A Comparison of Outcome between Two Different Age Groups after Intravenous Thrombolysis for Acute Ischemic Stroke of Anterior Circulation: A Single-Center Experience of 500 Cases.Asian journal of neurosurgery · 2025Article
- Refractory Thrombectomy: Incidence and Related Factors in a Third-Level Stroke Treatment Center.Journal of clinical medicine · 2025Article
- Hypoperfusion Intensity Ratio Less Than 0.4 Is Associated with Favorable Outcomes in Unsuccessfully Reperfused Acute Ischemic Stroke with Large-Vessel Occlusion.AJNR. American journal of neuroradiology · 2025Article
- 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
- Predicting Recanalization Failure With Conventional Devices During Endovascular Treatment Related to Vessel Occlusion.Stroke (Hoboken, N.J.) · 2024Article
- Associations between NIHSS sub-item scores and prognosis and intracranial hemorrhage after endovascular therapy for acute anterior circulation ischemic stroke.Frontiers in neurology · 2023Article
- Predictors of favorable outcome and mortality after endovascular thrombectomy in young Chinese patients with large vascular occlusions.Frontiers in neurology · 2023Article
- Mechanical thrombectomy failure in anterior circulation strokes: Outcomes and predictors of favorable outcome.European journal of neurology · 2022Article
- Clinical multidimensional prediction model for futile reperfusion in acute ischemic stroke after endovascular thrombectomy.Frontiers in neurologyArticle
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Authors and funding
19 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeDespite continuous improvement and growing knowledge in the endovascular therapy of large vessel occlusion stroke (LVOS), mechanical thrombectomy (MT) still fails to obtain satisfying intracranial recanalization in 10% to 15% of cases. However, little is known regarding clinical and radiological outcomes among this singularly underexplored subpopulation undergoing failed MT. We aimed to investigate the outcome after failed MT and identify predictive factors of favorable outcome despite recanalization failure.
methodsWe conducted a retrospective analysis of consecutive patients prospectively included in the ongoing observational multicenter Endovascular Treatment in Ischemic Stroke registry from January 2015 to September 2020. Patients presenting with anterior circulation LVOS treated with MT but experiencing failed intracranial recanalization defined as final modified Thrombolysis In Cerebral Infarction (mTICI) score of 0, 1 and 2a were included. Clinical and radiological outcomes were assessed along with the exploration of predictive factors of Day-90 favorable outcome.
resultsThe study population comprised 533 patients. Mean age was 68.8 ± 16 years, and median admission National Institutes of Health Stroke Scale (NIHSS) and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) were 17 (IQR 12-21) and 7 (IQR 5-8), respectively. Favorable outcomes were observed in 85 patients (18.2%) and 186 died (39.0%). The rate of symptomatic intracranial hemorrhage was 14.1%. In multivariable analysis, younger age (odds ratio [OR] 0.96, 95% CI 0.94-0.98, p < 0.001), a lower admission NIHSS (OR 0.87, 95% CI 0.83-0.91, p < 0.001), a lower number of MT passes (OR 0.77, 95% CI 0.77-0.87, p < 0.001), a lower delta ASPECTS between initial and Day-1 imaging (OR 0.83, 95% CI 0.71-0.98, p = 0.026) and stroke etiology [significant difference among etiological subtypes (p = 0.024) with a tendency toward more favorable outcomes for dissection (OR 2.01, 95% CI 0.71-5.67)] were significantly associated with a 90-day favorable outcome.
conclusionsIn this large retrospective analysis of a multicenter registry, we quantified the poor outcome after MT failure. We also identified factors associated with favorable outcome despite recanalization failure that might influence therapeutic management.
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