PMID- 37290931
OWN - NLM
STAT- MEDLINE
DCOM- 20240501
LR  - 20240501
IS  - 2059-8696 (Electronic)
IS  - 2059-8688 (Linking)
VI  - 9
IP  - 2
DP  - 2024 Apr 30
TI  - Thrombus migration in patients with acute ischaemic stroke undergoing 
      endovascular thrombectomy.
PG  - 126-133
LID - 10.1136/svn-2022-002257 [doi]
AB  - OBJECTIVE: The impact of thrombus migration (TM) prior to endovascular 
      thrombectomy (EVT) on clinical outcomes and revascularisation rates remains 
      unknown. We aimed to examine whether preinterventional TM modifies the treatment 
      effects of direct EVT versus bridging EVT in acute large vessel occlusion 
      patients. METHODS: All patients undergoing catheter angiography in the Direct 
      Intra-arterial thrombectomy in order to Revascularise acute ischaemic stroke 
      patients with large vessel occlusion Efficiently in Chinese Tertiary hospitals: A 
      Multicentre randomised clinical Trial were included. TM was determined by 
      radiologists unaware of the study by analysing discrepancies between computed 
      tomographic angiography at baseline and first-run digital subtraction angiography 
      before EVT. The primary outcome was the score on the modified Rankin scale (mRS) 
      assessed at 90 days. RESULTS: Of 627 included patients, the TM rate was 11.3% 
      (71/627). In the multivariable logistic regression model, baseline National 
      Institutes of Health Stroke Scale score (adjusted OR 0.956, 95% CI 0.916 to 
      0.999; p=0.043) and intravenous thrombolysis (adjusted OR 2.614, 95% CI 1.514 to 
      4.514; p<0.001) were independently associated with TM. The patients with TM were 
      less likely to be completely recanalised than those without TM (21.27% vs 36.23%, 
      p=0.040). The interaction of TM and the EVT treatment effect did not 
      significantly affect mRS shift analysis (p=0.687) or mRS scores of 0 to 1 
      (p=0.436). CONCLUSION: Preinterventional TM does not modify the treatment effects 
      of direct versus bridging EVT on functional outcomes in patients with acute 
      ischaemic stroke with anterior large vessel occlusion. TM leads to a lower 
      complete recanalisation rate.
CI  - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Tan, ZeFeng
AU  - Tan Z
AUID- ORCID: 0000-0001-8284-612X
AD  - Neurology, First People's Hospital of Foshan, Foshan, Guangdong, China.
AD  - Department of Neurology, Jinan University First Affiliated Hospital, Guangzhou, 
      Guangdong, China.
FAU - Zhang, Lei
AU  - Zhang L
AUID- ORCID: 0000-0001-5559-6292
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
FAU - Huang, Li'an
AU  - Huang L
AD  - Department of Neurology, Jinan University First Affiliated Hospital, Guangzhou, 
      Guangdong, China.
FAU - Qiao, Hongyu
AU  - Qiao H
AD  - Department of Neurology, Jinan University First Affiliated Hospital, Guangzhou, 
      Guangdong, China.
FAU - Guan, Min
AU  - Guan M
AD  - Department of Neurology, Jinan University First Affiliated Hospital, Guangzhou, 
      Guangdong, China.
FAU - Yang, Bing
AU  - Yang B
AD  - Department of Neurology, Jinan University First Affiliated Hospital, Guangzhou, 
      Guangdong, China.
FAU - Yang, Pengfei
AU  - Yang P
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
FAU - Zhang, Yongwei
AU  - Zhang Y
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
FAU - Shen, Hongjian
AU  - Shen H
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
FAU - Zhou, Yu
AU  - Zhou Y
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
FAU - Hong, Bo
AU  - Hong B
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
FAU - Shi, Huaizhang
AU  - Shi H
AD  - Department of Neurosurgery, First Affiliated Hospital of Harbin Medical 
      University, Harbin, China.
FAU - Han, Hongxing
AU  - Han H
AD  - Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China.
FAU - Leng, Xinyi
AU  - Leng X
AUID- ORCID: 0000-0001-7300-6647
AD  - Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
FAU - Dong, Yi
AU  - Dong Y
AUID- ORCID: 0000-0001-6630-112X
AD  - Neurology, Huashan Hospital Fudan University, Shanghai, China.
FAU - Lian, Changlin
AU  - Lian C
AD  - Neurology, First People's Hospital of Foshan, Foshan, Guangdong, China.
FAU - Chen, Wenhuo
AU  - Chen W
AD  - Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou 
      Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
FAU - Xu, Anding
AU  - Xu A
AUID- ORCID: 0000-0003-3154-0985
AD  - Department of Neurology, Jinan University First Affiliated Hospital, Guangzhou, 
      Guangdong, China tlil@jnu.edu.cn.
AD  - Stroke Center, Jinan University First Affiliated Hospital, Guangzhou, Guangdong, 
      China.
FAU - Liu, Jianmin
AU  - Liu J
AD  - Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, 
      China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20240430
PL  - England
TA  - Stroke Vasc Neurol
JT  - Stroke and vascular neurology
JID - 101689996
SB  - IM
MH  - Humans
MH  - *Thrombectomy/adverse effects
MH  - Male
MH  - Female
MH  - *Endovascular Procedures/adverse effects/instrumentation
MH  - Aged
MH  - *Ischemic Stroke/therapy/diagnostic imaging/physiopathology/diagnosis
MH  - Treatment Outcome
MH  - Middle Aged
MH  - China
MH  - Time Factors
MH  - Risk Factors
MH  - *Disability Evaluation
MH  - Recovery of Function
MH  - Intracranial Thrombosis/diagnostic imaging/therapy/physiopathology
MH  - Cerebral Angiography
MH  - Computed Tomography Angiography
MH  - Functional Status
MH  - Risk Assessment
OTO - NOTNLM
OT  - Cerebral Infarction
OT  - Stroke
OT  - Thrombectomy
OT  - Thromboembolism
OT  - Thrombolysis
COIS- Competing interests: None declared.
EDAT- 2023/06/09 01:09
MHDA- 2024/05/02 00:49
CRDT- 2023/06/08 21:38
PHST- 2022/12/20 00:00 [received]
PHST- 2023/04/12 00:00 [accepted]
PHST- 2024/05/02 00:49 [medline]
PHST- 2023/06/09 01:09 [pubmed]
PHST- 2023/06/08 21:38 [entrez]
AID - svn-2022-002257 [pii]
AID - 10.1136/svn-2022-002257 [doi]
PST - epublish
SO  - Stroke Vasc Neurol. 2024 Apr 30;9(2):126-133. doi: 10.1136/svn-2022-002257.