Portal de Periódicos da CAPES

First pass effect as an independent predictor of functional outcomes in medium vessel occlusions: An analysis of an international multicenter study

2023; SAGE Publishing; Volume: 9; Issue: 1 Linguagem: Inglês

10.1177/23969873231208276

2396-9881

Răzvan Alexandru Radu, Vincent Costalat, Robert Fahed, Sherief Ghozy, James E. Siegler, Hamza Shaikh, Jane Khalife, Mohamad Abdalkader, Piers Klein, Thanh N. Nguyen, Jeremy J. Heit, Ahmad Sweid, Kareem El Naamani, Robert W. Regenhardt, Jose Danilo Bengzon Diestro, Nicole M Cancelliere, Abdelaziz Amllay, Lukas Meyer, Anne Dusart, Flavio Bellante, Géraud Forestier, Aymeric Rouchaud, Suzana Saleme, Charbel Mounayer, Jens Fiehler, Anna Luisa Kühn, Ajit S Puri, Christian Dyzmann, Peter Kan, Marco Colasurdo, Gaultier Marnat, Jérôme Berge, Xavier Barreau, Igor Sibon, Simona Nedelcu, Nils Henninger, Maéva Kyheng, Thomas R. Marotta, Christopher J. Stapleton, James D. Rabinov, Takahiro Ota, Shogo Dofuku, Leonard L.L. Yeo, Benjamin Yong‐Qiang Tan, Juan Carlos Martínez-Gutiérrez, Sergio Salazar‐Marioni, Sunil A. Sheth, Leonardo Renieri, Carolina Capirossi, Ashkan Mowla, Stavropoula I Tjoumakaris, Pascal Jabbour, Priyank Khandelwal, Arundhati Biswas, Frédéric Clarençon, Mahmoud Elhorany, Kévin Premat, Iacopo Valente, Alessandro Pedicelli, João Pedro Filipe, Ricardo Varela, Miguel Quintero‐Consuegra, Nestor R. Gonzalez, Markus Möhlenbruch, Jessica Jesser, Illario Tancredi, Adrien ter Schiphorst, Vivek Yedavalli, Pablo Harker, Lina Chervak, Yasmin Aziz, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Monika Killer‐Oberpfalzer, Christoph J. Griessenauer, Ajith J. Thomas, Cheng‐Yang Hsieh, David S. Liebeskind, Andrea Alexandre, Tobias D. Faizy, Charlotte S. Weyland, Aman B. Patel, Vítor Mendes Pereira, Boris Lubicz, Adam A. Dmytriw, Adrien Guenego,

Peripheral Artery Disease Management

Introduction: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce. Patients and Methods: We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale 0–2 at 3 months. Results: Eight hundred thirty-six patients with a final mTICI ⩾ 2b were included in this analysis. FPE was observed in 302 patients (36.1%). In multivariable analysis, hypertension (aOR 1.55, 95% CI 1.10–2.20) and lower baseline NIHSS score (aOR 0.95, 95% CI 0.93–0.97) were independently associated with an FPE. Good outcomes were more common in the FPE versus non-FPE group (72.8% vs 52.8%), and FPE was independently associated with favorable outcome (aOR 2.20, 95% CI 1.59–3.05). 90-day mortality and intracranial hemorrhage (ICH) were significantly lower in the FPE group, 0.43 (95% CI, 0.25–0.72) and 0.55 (95% CI, 0.39–0.77), respectively. Conclusion: Over 2/3 of patients with MeVOs and FPE in our cohort had a favorable outcome at 90 days. FPE is independently associated with favorable outcomes, it may reduce the risk of any intracranial hemorrhage, and 3-month mortality.