Citations 1
Abstract TP197: Impact of First-Pass Effect on Clinical Outcomes in Stroke Patients With Low Aspects
Kasab, Sami Al , Maier, Ilko , Kim, Joon‐Tae , Rai, Ansaar , Starke, Robert M. , Grossberg, Jonathan A , Tanweer, Omar , Polifka, Adam , Park, Min S. , Brinjikji, Waleed , Moss, Mark, Dumont, Travis M., Williamson, Richard , Kan, Peter , Chowdhry, Shakeel , Ezzeldin, Mohamad , Spiotta, Alejandro M , Elawady, Sameh Samir , Sowlat, Mohammad‐Mahdi , Matsukawa, Hidetoshi , Cunningham, Conor M. , Orscelik, Atakan , Zandpazandi, Sara , Jabbour, Pascal , Wolfe, Stacey Q , Samaniego, Edgar A , Arthur, Adam Stephen , Yoshimura, Shinichi , Cuellar, Hugo , Alawieh, Ali , Romano, Daniele G., Mascitelli, Justin R , Fragata, Isabel , Osbun, Joshua W , Crosa, Roberto , Matouk, Charles , Levitt, Michael R. , Navía, Pedro , Leacy, Reade De
Stroke | February 1, 2024 | Volume: 55 | Issue: Suppl_1 | Pages: No page available
Introduction: The first-pass effect (FPE), defined as a complete or near-complete recanalization after a single pass of a mechanical thrombectomy (MT) device, has been linked to favorable clinical outcomes. However, its effectiveness in acute ischemic stroke (AIS) patients with low ASPECTS (Alberta Stroke Program Early CT Score 2-5) has not been validated. Method: We utilized data from STAR, a multicenter database of 84 centers worldwide, to conduct a retrospective, cohort study on patients who underwent MT for internal carotid artery (ICA) or M1 occlusion presenting with ASPECTS 2-5. We compared the outcomes of patients who achieved FPE (successful recanalization with an mTICI score of 2c or higher in one pass) to those who did not. The primary outcome was a 90-day favorable outcome, defined as mRS 0-3. Secondary outcomes included any intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality. Results: Out of 10,229 patients in the STAR database, 250 patients met our inclusion criteria. Among those, 60 (24%) achieved FPE. There were no significant differences between the two groups in baseline, imaging, and procedural characteristics. FPE was significantly associated with higher odds of 90-day mRS 0-3 (adjusted odds ratio (aOR): 2.17, 95% confidence interval (CI): 1.04 - 4.20; P-value: 0.04) and lower rates of ICH (OR: 0.49, 95% CI: 0.25 - 0.93, P-value: 0.03). However, there was no significant difference in sICH rates (OR: 0.84, 95% CI: 0.31 - 2.04, P-value: 0.70). Conclusion: Achieving FPE in AIS stroke patients with low ASPECTS was associated with significantly higher rates of good functional outcomes and lower rates of ICH.