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Mechanical thrombectomy for recurrent large vessel occlusion
P Bhogal1, M AlMatter2, V Hellstern2
1The Royal London Hospital, Whitechapel Road, London, UK.
Summary
Mechanical thrombectomy (MT) for recurrent large vessel occlusion (LVO) is safe and technically similar to initial procedures. While outcomes may differ slightly, recurrent MT is a viable option for LVO patients.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Mechanical thrombectomy (MT) is effective for large vessel occlusion (LVO) stroke.
- Data on recurrent LVO treated with MT is limited.
- Understanding safety and efficacy in recurrent cases is crucial.
Purpose of the Study:
- To evaluate the safety and effectiveness of MT for recurrent LVO.
- To compare technical aspects and patient outcomes between initial and recurrent MT procedures.
Main Methods:
- Retrospective review of a prospectively maintained database (2008-2018).
- Inclusion of patients who underwent more than one MT procedure for LVO.
- Data collection included demographics, comorbidities, stroke characteristics, procedural details, and outcomes (mRS at 90 days).
Main Results:
- 25 patients underwent 52 MT procedures; 68% were female, average age 70 years.
- Median time between strokes was 71 days; 86.5% of strokes were cardioembolic.
- No significant difference in procedure time, passes, or TICI scores between initial and recurrent MT.
- A significant difference in modified Rankin Scale (mRS) was observed after the 1st and 2nd events (p=0.014).
Conclusions:
- Recurrent mechanical thrombectomy for LVO can be performed safely.
- Technical aspects of recurrent MT are comparable to initial procedures.
- While functional outcomes may differ, MT remains a viable treatment for recurrent LVO.
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