Recanalization is more important than procedure time on outcome of thrombectomy in acute vertebrobasilar artery occlusion.

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Thrombosis and Thrombolysis Pub Date : 2025-03-13 DOI:10.1007/s11239-025-03082-6
Wenya Lan, Danyu Feng, Kefan Qiu, Mingyang Du, Feng Qiu, Lulu Xiao, Wen Sun, Zhongming Qiu, Hongfei Sang, Lingfei Li, Kefeng Luan, Xinfeng Liu, Hui Cao
{"title":"Recanalization is more important than procedure time on outcome of thrombectomy in acute vertebrobasilar artery occlusion.","authors":"Wenya Lan, Danyu Feng, Kefan Qiu, Mingyang Du, Feng Qiu, Lulu Xiao, Wen Sun, Zhongming Qiu, Hongfei Sang, Lingfei Li, Kefeng Luan, Xinfeng Liu, Hui Cao","doi":"10.1007/s11239-025-03082-6","DOIUrl":null,"url":null,"abstract":"<p><p>Longer procedure time (PT) predicts worse prognosis after endovascular treatment (EVT) in acute vertebrobasilar artery occlusion (VBAO), but it remains unknown whether it is worth pursuing recanalization when the PT is obviously extended. Patients with acute VBAO who received EVT were retrospectively enrolled from 21 stroke centers in China from December 2015 to December 2018. Multivariable logistic analysis was performed to analyze the associations of PT with favorable outcome (defined as modified Rankin Scale score of 0 to 3) and mortality at 90 days. A total of 541 patients with median age of 64 years (IQR, 55-73) were included. The median baseline National institutes of Health stroke scale score was 23 (IQR, 14-28) and PT was 110 min (IQR, 74-156). The rate of favorable outcome was 36.5% in patients with PT 111-155 min (adjusted OR 0.51 [95% CI 0.28-0.92]) and 33.3% in patients with PT > 155 min (adjusted OR 0.52 [95% CI 0.29-0.93]) compared with 42.9% in patients with PT ≤ 75 min. Compared with the PT ≤ 75 min, PT of 111-155 min (adjusted OR 1.96 [95% CI 1.11-3.46]) and PT > 155 min (adjusted OR 2.10 [95% CI 1.21-3.66]) were associated with increased risks of mortality. Recanalization within four PT intervals were consistently associated with better outcomes compared with failure of recanalization (all P < 0.05). For acute VBAO patients treated with EVT, recanalization regardless of PT was associated with improved prognosis than failure of recanalization, supporting the continued pursuit of recanalization despite the PT being obviously extended. The findings need validation in randomized controlled trials.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Thrombosis and Thrombolysis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11239-025-03082-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Longer procedure time (PT) predicts worse prognosis after endovascular treatment (EVT) in acute vertebrobasilar artery occlusion (VBAO), but it remains unknown whether it is worth pursuing recanalization when the PT is obviously extended. Patients with acute VBAO who received EVT were retrospectively enrolled from 21 stroke centers in China from December 2015 to December 2018. Multivariable logistic analysis was performed to analyze the associations of PT with favorable outcome (defined as modified Rankin Scale score of 0 to 3) and mortality at 90 days. A total of 541 patients with median age of 64 years (IQR, 55-73) were included. The median baseline National institutes of Health stroke scale score was 23 (IQR, 14-28) and PT was 110 min (IQR, 74-156). The rate of favorable outcome was 36.5% in patients with PT 111-155 min (adjusted OR 0.51 [95% CI 0.28-0.92]) and 33.3% in patients with PT > 155 min (adjusted OR 0.52 [95% CI 0.29-0.93]) compared with 42.9% in patients with PT ≤ 75 min. Compared with the PT ≤ 75 min, PT of 111-155 min (adjusted OR 1.96 [95% CI 1.11-3.46]) and PT > 155 min (adjusted OR 2.10 [95% CI 1.21-3.66]) were associated with increased risks of mortality. Recanalization within four PT intervals were consistently associated with better outcomes compared with failure of recanalization (all P < 0.05). For acute VBAO patients treated with EVT, recanalization regardless of PT was associated with improved prognosis than failure of recanalization, supporting the continued pursuit of recanalization despite the PT being obviously extended. The findings need validation in randomized controlled trials.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
9.20
自引率
0.00%
发文量
112
审稿时长
4-8 weeks
期刊介绍: The Journal of Thrombosis and Thrombolysis is a long-awaited resource for contemporary cardiologists, hematologists, vascular medicine specialists and clinician-scientists actively involved in treatment decisions and clinical investigation of thrombotic disorders involving the cardiovascular and cerebrovascular systems. The principal focus of the Journal centers on the pathobiology of thrombosis and vascular disorders and the use of anticoagulants, platelet antagonists, cell-based therapies and interventions in scientific investigation, clinical-translational research and patient care. The Journal will publish original work which emphasizes the interface between fundamental scientific principles and clinical investigation, stimulating an interdisciplinary and scholarly dialogue in thrombosis and vascular science. Published works will also define platforms for translational research, drug development, clinical trials and patient-directed applications. The Journal of Thrombosis and Thrombolysis'' integrated format will expand the reader''s knowledge base and provide important insights for both the investigation and direct clinical application of the most rapidly growing fields in medicine-thrombosis and vascular science.
期刊最新文献
Recanalization is more important than procedure time on outcome of thrombectomy in acute vertebrobasilar artery occlusion. Intravenous thrombolysis with tenecteplase versus alteplase in acute ischemic stroke tandem occlusions: a systematic review and meta-analysis of current available literature. Immune checkpoint inhibitors and myocardial infarction. Incidence of arterial and venous thromboembolism in cancer patients- insights from more than 5,000,000 patients. Predictors of venous thromboembolic events in hospitalized patients with COVID-19.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1