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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
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First pass effect in posterior circulation occlusions: Analysis from the CICAT registry
Mikel Terceño1,2, Yolanda Silva1, Saima Bashir1
1Stroke Unit, Department of Neurology, Girona Biomedical Research Institute (IDIBGI), Doctor Josep Trueta Hospital, Girona, Spain.
Summary
First pass effect (FPE) predicts functional independence in posterior circulation large vessel occlusion (PC-LVO) stroke patients. Achieving FPE in a single pass is linked to better outcomes compared to multiple passes.
Area of Science:
- Neurology
- Interventional Neurology
- Stroke Medicine
Background:
- The first pass effect (FPE) is a known predictor of functional independence in anterior circulation ischemic strokes.
- Its predictive value in posterior circulation large vessel occlusion (PC-LVO) remains uncertain.
Purpose of the Study:
- To investigate the frequency, characteristics, and predictors of FPE in PC-LVO patients.
- To determine the association between FPE and clinical outcomes in PC-LVO.
Main Methods:
- Analysis of the prospective CICAT Registry of 265 PC-LVO patients undergoing endovascular therapy (2016-2020).
- FPE defined as achieving modified Thrombolysis In Cerebral Infarction 3 in a single pass; multi-pass effect (MPE) if achieved in >1 pass.
- Multivariable analysis assessed FPE as an independent predictor of functional independence (modified Rankin Score 0-2) at 3-month follow-up.
Main Results:
- FPE was achieved in 39.6% of patients.
- FPE was independently associated with functional independence (aOR: 2.10, 95% CI 1.01-4.37), unlike MPE (aOR: 0.92, 95% CI 0.40-2.13).
- Predictors of FPE included direct aspiration, embolic stroke mechanism, and no general anesthesia.
Conclusions:
- FPE is an independent predictor of functional independence in PC-LVO.
- FPE is associated with significantly better outcomes compared to MPE in PC-LVO.
