Observational studyJournal of neurology2025
Key to better outcomes in stroke intervention: early versus complete reperfusion in first pass recanalization.
Observational study in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03356392 (German Stroke Registry - Endovascular Treatment), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
German Stroke Registry - Endovascular Treatment
Who cites it
2 citing papers in PubMed.
- Perioperative Determinants of Functional Outcome and Mortality After Mechanical Thrombectomy Under General Anesthesia.Journal of clinical medicine · 2026Article
- Predictors of futile recanalization after endovascular therapy in anterior circulation stroke with large core infarction.Frontiers in neurology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeFirst pass (FP) recanalization, defined as achieving mTICI 2b or higher in a single thrombectomy attempt, has been linked to better functional recovery in acute ischemic stroke patients. This study aimed to investigate whether the benefits of FP are primarily driven by higher rates of complete reperfusion (mTICI 3) or by faster procedure times.
methodsData from 3707 patients with middle cerebral artery occlusion and successful recanalization (mTICI 2b or higher) were extracted from the prospectively designed German Stroke Registry (2015-2021). Good functional outcomes were defined as a modified Rankin Scale (mRS) score of ≤ 2 at 90 days. Mediation analysis was used to evaluate the extent to which complete reperfusion (mTICI 3) and shorter groin puncture to recanalization time contributed to improved outcomes.
resultsFP recanalization was associated with significantly better functional outcomes: 46.9% of FP patients achieved an mRS ≤ 2 compared to 37.2% in the multi-pass group. Mediation analysis showed that only 14% of the improved outcomes with FP were explained by higher mTICI 3 rates, while 37% were attributed to faster recanalization times.
conclusionThe improved outcomes associated with FP recanalization are primarily driven by the speed of reperfusion rather than the degree of complete recanalization. This highlights the importance of minimizing procedure times and the number of thrombectomy attempts. Strategies aimed at optimizing treatment workflows and improving device design to prioritize early and efficient reperfusion after the FP are critical to improving patient outcomes (ClinicalTrials.gov identifier: NCT03356392).
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Registered trials
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