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Clot length does not impact outcome following thrombectomy.

P Gavriliuc1, R Kharouba1, J E Cohen2

  • 1Departments of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Journal of the Neurological Sciences
|October 12, 2018
PubMed
Summary

Clot length does not impact outcomes in patients with emergent large vessel occlusions (ELVO) undergoing thrombectomy. This finding suggests that clot length should not be a factor in deciding eligibility for this stroke treatment.

Keywords:
ClotOutcomeStrokeThrombectomy

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Area of Science:

  • Neuroscience
  • Interventional Neurology
  • Stroke Medicine

Background:

  • Intravenous tissue plasminogen activator (tPA) treatment outcomes in stroke patients with emergent large vessel occlusions (ELVO) are linked to clot length.
  • Limited data exists on the influence of clot length on outcomes following mechanical thrombectomy for ELVO.

Purpose of the Study:

  • To investigate the association between clot length and clinical outcomes in patients with ELVO undergoing mechanical thrombectomy.
  • To determine if clot length influences functional outcome, symptomatic intracranial hemorrhage (sICH), or mortality after thrombectomy for ELVO.

Main Methods:

  • Analysis of prospectively collected data from consecutive ELVO patients treated with thrombectomy.
  • Collection of demographic, risk factor, stroke severity, survival, and sICH data.
  • Measurement of clot length from pre-thrombectomy digital subtraction angiograms; functional outcome assessed using modified Rankin Scale (mRS) at 90 days.

Main Results:

  • Clot length did not differ between patients with favorable (mRS ≤ 2) and unfavorable outcomes.
  • Clot length did not significantly influence rates of symptomatic intracranial hemorrhage (sICH) or mortality.
  • Multivariate analysis indicated that age, stroke severity, number of passes, and neurological deficit change were significant outcome predictors, but clot length was not.

Conclusions:

  • Clot length does not affect functional outcomes, mortality, or sICH in patients undergoing thrombectomy for ELVO.
  • ELVO patients should not be excluded from thrombectomy solely based on clot length.