School of Medicine Publications and Presentations
Document Type
Article
Publication Date
2-25-2023
Abstract
Background
In patients with acute ischemic stroke, minimizing the time to revascularization can minimize neuronal death. First‐pass effect (FPE), defined as successful or complete revascularization of an occluded target vessel with 1 pass of a mechanical thrombectomy device(s), reduces the time to revascularization. The objective of this study was to determine the FPE rate, compare cases in which FPE was versus was not achieved, and determine predictors of good functional outcome at 90 days, in patients with large‐vessel occlusion acute ischemic stroke treated with the Penumbra System (Penumbra, Inc).
Methods
This study is a subset analysis of the COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D [3‐Dimensional] Revascularization Device) registry, a global, prospective, multicenter, observational registry. FPE rates were calculated. Subgroups who achieved versus did not achieve FPE were compared. Variables independently associated with good functional outcome at 90 days were determined.
Results
A total of 648 patients were included. FPE was achieved with a revascularization definition of modified thrombolysis in cerebral infarction score 2b to 3 in 56.8% of patients, with modified thrombolysis in cerebral infarction score 2c to 3 in 41.5%, and with modified thrombolysis in cerebral infarction score 3 in 31.8%. The percentage of patients who achieved good functional outcome at 90 days was higher for patients who achieved FPE than for patients who did not (P<0.01). Achieving FPE with modified thrombolysis in cerebral infarction score 2b to 3 was an independent predictor for good functional outcome at 90 days (adjusted odds ratio, 1.64; P=0.045).
Conclusions
For aspiration thrombectomy with the Penumbra System, achieving FPE was associated with a significantly higher rate of good functional outcome.
Recommended Citation
Fifi, J. T., Matsoukas, S., Hassan, A. E., & Zaidat, O. O. (2023). First‐Pass Effect With Aspiration Thrombectomy With the Penumbra System in Patients With Acute Ischemic Stroke: A Core Laboratory–Adjudicated Subset Analysis of the COMPLETE Registry. Stroke: Vascular and Interventional Neurology, 3(3), e000689. https://doi.org/10.1161/SVIN.122.000689
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Publication Title
Stroke: Vascular and Interventional Neurology
DOI
10.1161/SVIN.122.000689
Academic Level
faculty
Mentor/PI Department
Neurology
Comments
© 2023 The Authors. Published on behalf of the American Heart Association, Inc., and the Society of Vascular and Interventional Neurology by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.