Impact of double stent retriever configuration on first-pass effect in stroke: a multicenter study

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Efficient recanalization of occluded cerebral arteries is critical for acute ischemic stroke treatment.
• Double stent retrievers offer potential for enhanced first-pass recanalization rates.
• This study evaluates the double stent retriever technique's efficacy and safety in acute ischemic stroke.

Purpose of the Study:

• To assess the efficacy and safety of the double stent retriever technique for acute ischemic stroke.
• To identify predictors of achieving first-pass effect with double stent retrievers.
• To compare different deployment techniques and stent configurations.

Main Methods:

• Prospective multicenter study of 209 acute ischemic stroke patients.
• Treatment involved the Aperio Hybrid double stent retriever for anterior circulation occlusions.
• Deployment techniques (simultaneous/sequential) and configurations (Y-shaped/parallel) were analyzed.

Main Results:

• First-pass effect achieved in 72.7% of cases; 99.5% final recanalization.
• Y-shaped configuration significantly associated with higher first-pass rates (OR 2.59, P=0.02).
• Mild/moderate complications in 6.7%, severe in 1.5%; 3.3% symptomatic intracranial hemorrhage. Good 3-month outcome in 57.2%.

Conclusions:

• The double stent retriever technique, especially the Y-shaped configuration, is effective for high first-pass recanalization in acute ischemic stroke.
• The technique demonstrates an acceptable safety profile.
• This method holds promise for improving acute ischemic stroke treatment protocols.