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The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo

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Published on: December 19, 2025

Recanalization rates decrease with increasing thrombectomy attempts.

Y Loh¹, R Jahan, D L McArthur

¹Division of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. yincer@yahoo.com

AJNR. American Journal of Neuroradiology

|January 16, 2010

Summary

This summary is machine-generated.

For large intracranial arterial occlusions, three Merci retriever attempts appear optimal for recanalization. More than three attempts may decrease success rates and increase procedural complications.

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Area of Science:

Interventional Neurology
Vascular Neurology
Neurosurgery

Background:

The Merci retriever is increasingly used for reopening large intracranial arterial occlusions.
Determining the optimal number of retrieval attempts is crucial for maximizing recanalization rates.

Purpose of the Study:

To identify the optimal number of Merci retriever attempts for achieving successful recanalization.
To assess the relationship between the number of attempts and the likelihood of success or complications.

Main Methods:

Prospective tracking of consecutive patients undergoing Merci retrieval for large cerebral artery occlusions.
Analysis of internal carotid artery (ICA), middle cerebral artery (MCA) M1 segment, and vertebrobasilar occlusions.
Comparison of revascularization outcomes (AOL score) with the number of retrieval attempts.

Main Results:

A total of 97 patients with 115 arterial occlusions were analyzed.
A median of 3 attempts per vessel yielded a median AOL score of 2.
Up to 3 attempts correlated with successful revascularization (AOL 2 or 3); 4 or more attempts resulted in more failed recanalizations and complications (P = .006).

Conclusions:

Three Merci retriever attempts per target vessel occlusion represent the optimum in our experience.
Performing four or more attempts may not enhance recanalization chances and could increase complication risks.