First‐Line Stent Retriever Versus Contact Aspiration or Combined Technique for Endovascular Therapy of Posterior Cerebral Artery Occlusion Stroke: The PLATO Study-Reference-Cited by-同舟云学术

First‐Line Stent Retriever Versus Contact Aspiration or Combined Technique for Endovascular Therapy of Posterior Cerebral Artery Occlusion Stroke: The PLATO Study

Published:2024-01 Issue:1 Volume:4 Page:
ISSN:2694-5746
Container-title:Stroke: Vascular and Interventional Neurology
language:en
Short-container-title:SVIN

Author:

Nguyen Thanh N.¹²^ORCID,Abdalkader Mohamad²^ORCID,Qureshi Muhammad M.²³^ORCID,Michel Patrik⁴^ORCID,Strambo Davide⁴^ORCID,Strbian Daniel⁵^ORCID,Herweh Christian⁶^ORCID,Möhlenbruch Markus A.⁶^ORCID,Räty Silja⁵^ORCID,Olive‐Gadea Marta⁷^ORCID,Ribo Marc⁷^ORCID,Psychogios Marios⁸^ORCID,Fischer Urs⁹¹⁰^ORCID,Nguyen Anh¹¹^ORCID,Kuramatsu Joji B.¹²^ORCID,Haupenthal David¹²^ORCID,Köhrmann Martin¹³¹⁴^ORCID,Deuschl Cornelius¹⁵^ORCID,Escolà Jordi Kühne¹⁴^ORCID,Demeestere Jelle¹⁶¹⁷^ORCID,Vandewalle Lieselotte¹⁶¹⁷^ORCID,Yaghi Shadi¹⁸^ORCID,Shu Liqi¹⁸^ORCID,Puetz Volker¹⁹²⁰^ORCID,Kaiser Daniel P.O.²⁰²¹^ORCID,Kaesmacher Johannes²²^ORCID,Mujanovic Adnan²²^ORCID,Marterstock Dominique Cornelius²³^ORCID,Engelhorn Tobias²³^ORCID,Klein Piers²^ORCID,Haussen Diogo C.²⁴^ORCID,Mohammaden Mahmoud H.²⁴^ORCID,Fragata Isabel²⁵^ORCID,Cunha Bruno²⁵,Abdelhamid Hend²⁴^ORCID,Romoli Michele²⁶^ORCID,Diana Francesco²⁷^ORCID,Virtanen Pekka²⁸²⁹^ORCID,Lappalainen Kimmo²⁸²⁹^ORCID,Jesser Jessica⁶^ORCID,Clark Judith¹,Matsoukas Stavros³⁰^ORCID,Fifi Johanna T.³⁰^ORCID,Sheth Sunil A.³¹^ORCID,Salazar‐Marioni Sergio³¹^ORCID,Marto João Pedro³²^ORCID,Ramos João Nuno³³,Miszczuk Milena³⁴^ORCID,Riegler Christoph³⁵^ORCID,Poli Sven³⁶³⁷^ORCID,Poli Khouloud³⁶^ORCID,Jadhav Ashutosh P.³⁸^ORCID,Desai Shashvat M.³⁸^ORCID,Maus Volker³⁹⁴⁰^ORCID,Kaeder Maximilian³⁹^ORCID,Masoud Hesham E.⁴¹^ORCID,Suryadareva Neil⁴²,Mokin Maxim⁴³^ORCID,Siegler James E.⁴⁴^ORCID,Linfante Italo⁴⁵^ORCID,Dabus Guilherme⁴⁵^ORCID,Asdaghi Negar⁴⁶^ORCID,Saini Vasu⁴⁶^ORCID,Nolte Christian H.³⁵^ORCID,Siebert Eberhard³⁴^ORCID,Meinel Thomas R.⁴⁷^ORCID,Weyland Charlotte S.⁴⁸^ORCID,Hanning Uta⁴⁹^ORCID,Meyer Lukas⁴⁹^ORCID,Nogueira Raul G.⁴²^ORCID,Ringleb Peter A.⁵⁰,Nagel Simon⁵⁰⁵¹^ORCID

Affiliation:

1. Neurology Boston Medical Center Boston MA

2. Radiology Boston Medical Center Boston MA

3. Radiation Oncology Boston Medical Center Boston MA

4. Neurology Service Lausanne University Hospital University of Lausanne Switzerland

5. Neurology Helsinki University Hospital Finland

6. Neuroradiology Heidelberg University Hospital Germany

7. Neurology Hospital Universitario Vall d'Hebron Barcelona Spain

8. Basel University Hospital University of Basel Switzerland

9. Neurology University Hospital Basel Basel Switzerland

10. Neurology University Hospital Bern Bern Switzerland

11. Radiology University of Basel Switzerland

12. Neurology University of Erlangen‐Nuremberg Erlangen Germany

13. Neurology University Hospital Essen Essen Germany

14. Department of Neurology University Hospital Essen Essen Germany

15. Institute of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen Germany

16. Department of Neurosciences Experimental Neurology KU Leuven Leuven Belgium

17. Department of Neurology University Hospitals Leuven Leuven Belgium

18. Neurology Rhode Island Hospital RI

19. Neurology University Hospital Carl Gustav Carus Technische Universität Dresden Germany

20. Dresden Neurovascular Center University Hospital Carl Gustav Carus, Technische Universität Dresden Dresden Germany

21. Neuroradiology, University Hospital Carl Gustav Carus Technische Universität Dresden Germany

22. Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital University of Bern Bern Switzerland

23. Neuroradiology University of Erlangen‐Nuremberg Erlangen Germany

24. Neurology Grady Memorial Hospital Atlanta GA

25. Neuroradiology Centro Hospitalar Universitario de Lisboa Central Portugal

26. Neurology and Stroke Unit Department of Neuroscience Bufalini Hospital Cesena Italy

27. Interventional Neuroradiology Vall d'Hebron University Hospital Barcelona Spain

28. Radiology Helsinki University Hospital Finland

29. Radiology Helsinki University Hospital University of Helsinki Helsinki Finland

30. Neurosurgery Mount Sinai Health System NY

31. Neurology McGovern Medical School at UTHealth TX

32. Neurology Hospital de Egas Moniz Centro Hospitalar Lisboa Ocidental Portugal

33. Neuroradiology Hospital de Egas Moniz Centro Hospitalar Lisboa Ocidental Portugal

34. Neuroradiology Charité – Universitätsmedizin Berlin Freie Universität Berlin and Humboldt‐Universität Germany

35. Neurology Experimental Neurology and Center for Stroke Research Berlin (CSB) and Berlin Institute of Health (BIH) Charité – Universitätsmedizin Berlin Freie Universität Berlin and Humboldt‐Universität zu Berlin Germany

36. Neurology & Stroke University of Tübingen Germany

37. Hertie‐Institute for Clinical Brain Research University of Tübingen Germany

38. Neurosurgery Barrow Neurological Institute AZ

39. Radiology Neuroradiology and Nuclear Medicine University Hospital Knappschaftskrankenhaus Bochum Germany

40. Klinikum Aschaffenburg Aschaffenburg Germany

41. Neurology New York Upstate Medical University NY

42. Neurology University of Pittsburgh Medical Center PA

43. Neurosurgery University of South Florida FL

44. Cooper Neurological Institute NJ

45. Miami Neuroscience Institute FL

46. Neurology University of Miami Miller School of Medicine FL

47. Neurology Bern University Hospital University of Bern Switzerland

48. Neuroradiology University Hospital RWTH Aachen Germany

49. Diagnostic and Interventional Neuroradiology University Medical Center Hamburg‐Eppendorf Germany

50. Neurology Heidelberg University Hospital Germany

51. Neurology Heidelberg University Hospital Heidelberg Germany

Abstract

Background The optimal reperfusion technique in patients with isolated posterior cerebral artery (PCA) occlusion is uncertain. We compared clinical and technical outcomes with first‐line stent retriever (SR), contact aspiration (CA), or combined techniques in patients with isolated PCA occlusion. Methods This international case–control study was conducted at 30 sites in Europe and North America and included consecutive patients with isolated PCA occlusion presenting within 24 hours of time last seen well from January 2015 to August 2022. The primary outcome was the first‐pass effect (FPE), defined as expanded Treatment in Cerebral Infarction (TICI) 2c/3 on the first pass. Patients treated with SR, CA, or combined technique were compared with multivariable logistic regression. Results There were 326 patients who met inclusion criteria, 56.1% male, median age 75 (interquartile range 65–82) years, and median National Institutes of Health Stroke Scale score 8 (5–12). Occlusion segments were PCA‐P1 (53.1%), P2 (40.5%), and other (6.4%). Intravenous thrombolysis was administered in 39.6%. First‐line technique was SR, CA, and combined technique in 43 (13.2%), 106 (32.5%), and 177 (54.3%) patients, respectively; FPE was achieved in 62.8%, 42.5%, and 39.6%, respectively. FPE was lower in patients treated with first‐line CA or combined technique compared with SR (CA versus SR: adjusted odds ratio 0.45 [0.19–1.06]; P =0.07; combined versus SR: adjusted odds ratio 0.35 [0.016–0.80]; P =0.01). There were lower odds of functional independence (modified Rankin scale score 0–2) in the first‐line CA versus SR alone group (adjusted odds ratio 0.52 [0.28–0.95]; P =0.04). FPE was associated with higher rates of favorable outcomes (modified Rankin scale score 0–2: 58% versus 43.4%; P =0.01; modified Rankin scale score 0–1: 36.6% versus 25.8%; P =0.05). Overall, symptomatic intracranial hemorrhage was present in 5.6% (18/326) and mortality in 10.9% (35/326) without difference between first‐line technique. Conclusion In patients with isolated PCA occlusion, SR was associated with a higher rate of FPE compared with CA or combined techniques with no difference in final successful reperfusion. Functional independence at 90 days was more likely with first‐line SR compared with CA. FPE was associated with better 90‐day clinical outcomes.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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