Rescue intracranial stenting for failed posterior circulation thrombectomy: analysis from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Mohammaden Mahmoud H, Tarek Mohamed A, Aboul Nour Hassan, Haussen Diogo C, Fifi Johanna T, Matsoukas Stavros, Farooqui Mudassir, Ortega-Gutierrez Santiago, Zevallos Cynthia B, Galecio-Castillo Milagros, Hassan Ameer E, Tekle Wondwossen, Al-Bayati Alhamza R, Salem Mohamed M, Burkhardt Jan Karl, Pukenas Bryan, Cortez Gustavo M, Hanel Ricardo A, Aghaebrahim Amin, Sauvageau Eric, Hafeez Muhammad, Kan Peter, Tanweer Omar, Jumaa Mouhammad, Zaidi Syed F, Oliver Marion, Sheth Sunil A, Nahhas Michael, Salazar-Marioni Sergio, Khaldi Ahmad, Li Hanzhou, Kuybu Okkes, Abdalkader Mohamad, Klein Piers, Peng Sophia, Alaraj Ali, Nguyen Thanh N, Nogueira Raul G
Аннотация
METHODS: This is a retrospective analysis of the Stenting and Angioplasty in NeuroThrombectomy (SAINT) study, a multicenter collaboration involving prospectively collected databases. Patients were included if they had posterior circulation stroke and failed MT. The cohort was divided into two groups: FRRS+ and FRRS- (defined as modified Thrombolysis In Cerebral Infarction (mTICI) score 0-2a). The primary outcome was a shift in the degree of disability as measured by the modified Rankin Scale (mRS) at 90 days. Secondary outcomes included mRS 0-2 and mRS 0-3 at 90 days. Safety measures included rates of symptomatic intracranial hemorrhage (sICH), procedural complications, and 90-day mortality. Sensitivity and subgroup analyses were performed to identify outcomes in a matched cohort and in those with VBO, respectively.
RESULTS: A total of 152 failed thrombectomies were included in the analysis. FRRS+ (n=84) was associated with increased likelihood of lower disability (acOR 2.24, 95% CI 1.04 to 4.95, P=0.04), higher rates of mRS 0-2 (26.8% vs 12.5%, aOR 4.43, 95% CI 1.22 to 16.05, P=0.02) and mRS 0-3 (35.4% vs 18.8%, aOR 3.13, 95% CI 1.08 to 9.10, P=0.036), and lower mortality (42.7% vs 59.4%, aOR 0.40, 95% CI 0.17 to 0.97, P=0.04) at 90 days compared with FRRS- (n=68). The rates of sICH and procedural complications were comparable between the groups. Sensitivity and subgroup analyses showed similar results.
CONCLUSION: In patients with posterior circulation stroke who had failed MT, RS resulted in better functional outcomes with comparable safety profile to procedure termination.