ArticleEuropean journal of medical research2025
The effect of first pass effect in mechanical thrombectomy for acute terminal internal carotid artery occlusion.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThis study aimed to elucidate the impact of the first-pass effect (PFE) on patients with acute terminal internal carotid artery occlusion.
methodsWe conducted a retrospective analysis of patients with acute terminal internal carotid artery occlusion who underwent endovascular treatment. PFE was defined as achieving complete revascularization with a single use of the thrombectomy device, without the requirement for salvage therapy during the procedure. The primary functional outcome was measured using the 90-day modified Rankin Scale (mRS). mRS score of 0-3 was defined as a favorable outcome. A comprehensive assessment was performed on baseline patient characteristics, procedural parameters, and clinical outcomes. Multivariate analysis was employed to determine the association between PFE and 90-day functional outcomes.
resultsA total of 150 patients were included, of which 36 (24%) achieved PFE. Compared to the non-PFE group, the PFE group exhibited lower rates of general anesthesia, higher rates of intravenous thrombolysis and aspiration thrombectomy, and a shorter puncture-to-recanalization time. When contrasted with the unfavorable outcome group, the favorable outcome group presented with lower NIHSS scores, shorter puncture-to-recanalization durations, a reduced prevalence of atrial fibrillation, and a higher proportion of PFE. Multivariate analysis revealed that PFE was significantly associated with favorable functional outcomes (mRS 0-3, 49.12% vs. 72.22%; adjusted odds ratio [aOR], 3.78; 95% confidence interval [CI], 1.21-11.81; P = 0.022), yet showed no significant association with secondary or safety outcomes.
conclusionThis study demonstrates that among patients with acute terminal internal carotid artery occlusion who underwent endovascular treatment, 24% achieved FPE, which was associated with improved 90-days functional outcome.
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