Impact of Temporary Opening Using a Stent Retriever on Clinical Outcome in Acute Ischemic Stroke

Dongbeom Song, Ji Hoe Heo, Dong Ik Kim, Dong Joon Kim, Byung Moon Kim, Kijeong Lee, Joonsang Yoo, Hye Sun Lee, Hyo Suk Nam and Young Dae Kim

PLOS ONE, 2015, vol. 10, issue 4, 1-9

Abstract: Background: Stent retriever has a distinct ability to restore blood flow temporarily before achieving final reperfusion. There has been a limited report regarding the clinical impact of it. We investigated if temporary opening of occluded vessels using a stent retriever before final reperfusion might improve clinical outcome in acute ischemic stroke patients who received the endovascular reperfusion treatment. Methods: We enrolled consecutive ischemic stroke patients who had an initial occlusive lesion in the anterior circulation and achieved final reperfusion (Thrombolysis In Cerebral Infarction [TICI] ≥2) by endovascular treatment. Temporary opening was defined as the presence of ante grade flow (TICI≥2) during deployment of a stent retriever. Favorable outcome was defined as a modified Rankin scale score≤2 at 90 day. Results: A total of 98 patients were included in the study and temporary opening was achieved in 49 (50%). Temporary opening was associated with favorable outcome (odds ratio, 7.825; 95% confidence interval, 1.592–38.461; p = 0.011) in the multivariate analysis. The probability of having a favorable outcome tended to decrease as time from onset to final reperfusion increased in patients without temporary opening. However, this trend was not evident in the patient with temporary opening. The beneficial effect of temporary opening on clinical outcome seemed to be present in patients with good collaterals but not in patients with poor collaterals. Conclusions: Temporary opening of occluded vessel using a stent retriever may be beneficial for improving clinical outcome in acute ischemic stroke patients.

Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0124551

DOI: 10.1371/journal.pone.0124551

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