Related Experiment Video
Updated: Aug 27, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Successful Reperfusion is Associated with Favorable Functional Outcome despite Vessel Perforation during
C Ducroux1,2,3, W Boisseau4,5, A Y Poppe1,2,6
1From the Department of Neurosciences (C.D., A.Y.P., N.D., Y.D. L.C.G., C.O., C.S., G.J.), Faculté de médecine, Université de Montréal, Montréal, Quebec. Canada.
Background:
Arterial perforation is a potentially serious complication during endovascular thrombectomy.
Purpose:
Our aim was to describe interventional approaches after arterial perforation during endovascular thrombectomy and to determine whether reperfusion remains associated with favorable outcome despite this complication.
Data Sources:
Data from consecutive patients with acute stroke undergoing endovascular thrombectomy were retrospectively collected between 2015 to 2020 from a single-center cohort, and a systematic review was performed using PubMed, EMBASE, and Ovid MEDLINE up to June 2020.
Study Selection:
Articles reporting functional outcome after arterial perforation during endovascular thrombectomy were selected.
Data Analysis:
Functional outcomes of patients achieving successful reperfusion (TICI 2b/3) were compared with outcomes of those with unsuccessful reperfusion in our single-center cohort. We then summarized the literature review to describe interventional approaches and outcomes after arterial perforation during endovascular thrombectomy.
Data Synthesis:
In our single-center cohort, 1419 patients underwent endovascular thrombectomy, among whom 32 (2.3%) had vessel perforation and were included in the analysis. The most common hemostatic strategy was watchful waiting (71% of cases). Patients with successful reperfusion had a higher proportion of favorable 90-day mRS scores (60% versus 12.5%; P = .006) and a lower mortality rate (13.3% versus 56.3%, P = .01) than patients without successful reperfusion. Thirteen articles were included in the systematic review. Successful reperfusion also appeared to be associated with better outcomes.
Limitations:
Given the low number of published reports, we performed only a descriptive analysis.
Conclusions:
Arterial perforation during endovascular thrombectomy is rare but is associated with high mortality rates and poor outcome. However, successful reperfusion remains correlated with favorable outcome in these patients.
