Clinical Usefulness of Waiting after Stent Deployment in Mechanical Thrombectomy: Effect of the Clot Integration

Pulling a retriever stent after several minutes of waiting time is a popular technique in mechanical thrombectomy with a stent retriever, but little data exist on the actual effects of waiting after stent deployment.

We conducted a multicenter retrospective study of consecutive 210 patients separated into 2 groups, a waiting after stent deployment group and a nonwaiting group. A comparative analysis was performed in terms of clinical and radiologic outcomes and complications with respect to multiple categories.

There were no significant differences in baseline characteristics and clinical outcomes between the 2 groups. However, compared with the nonwaiting group, the waiting group had a higher rate of one-pass procedures, a lower mean number of stent passages, and a shorter procedure time (P = 0.021, 0.014, and 0.004, respectively). The proportion of patients with successful recanalization was also higher in the waiting group (P = 0.038). In multivariate analysis, waiting after stent deployment was a predictive factor for successful recanalization (odds ratio, 1.60; 95% confidence interval, 1.110-2.090; P = 0.02).

Waiting after stent deployment can lead to a more successful recanalization with a smaller number of stent passages and less distal emboli. More randomized controlled trials are needed to support these findings.