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

Conclusions

For aspiration thrombectomy with the Penumbra System, achieving FPE was associated with a significantly higher rate of good functional outcome.

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.

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International 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

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