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Updated: Mar 15, 2026
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
Importance of truncal-type occlusion in stentriever-based thrombectomy for acute stroke
Jang-Hyun Baek1, Byung Moon Kim2, Dong Joon Kim1
1From the Department of Neurology (J.-H.B.), National Medical Center; Departments of Radiology (B.M.K., D.J.K.) and Neurology (J.H.H., H.S.N., D.S.), Severance Hospital Stroke Center, Yonsei University College of Medicine; and Department of Neurology (O.Y.B.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Objective:
To investigate whether angiographically defined occlusion type could predict of the etiology of acute intracranial large artery occlusion and the stentriever response.
Methods:
We reviewed consecutive patients with acute intracranial large artery occlusion who underwent endovascular treatment and examined their workups for embolic sources. Patient demographics, laboratory findings, hyperdense artery sign, and angiographic occlusion type (truncal-type or branching-site occlusion) were compared between embolic sources (+) and (-) groups. These variables were also compared between stentriever failure and success groups. Details of endovascular procedures were also compared according to occlusion type.
Results:
A total of 259 patients (mean age 70.3 years; M:F = 132:127) were finally included. Of these patients, 216 (83.4%) were assigned to the embolic sources (+) group after thorough evaluation. Young age, no coronary artery disease, and truncal-type occlusion (odds ratio [OR] 9.07; 95% confidence interval [CI] 3.74-22.0) were independently associated with the embolic source (-) group. Of the overall group, 224 patients (86.5%) underwent stentriever-based endovascular treatment. Hypertension, diabetes, high C-reactive protein level, and truncal-type occlusion (OR 32.2; 95% CI 7.78-133.0) were independent predictors of stentriever failure. Truncal-type occlusion was associated with more reocclusion (77.3% vs 5.0%), resulting in recanalization failure by the stentriever (81.8% vs 20.3%), a longer puncture-to-recanalization time (118.0 vs 49.5 minutes), and more rescue treatment for final successful recanalization (78.9% vs 7.0%).
Conclusions:
Angiographic occlusion type is an independent predictor of stentriever refractoriness and of the underlying stroke mechanism.
