Matched-Pair Analysis of Patients With Large-Vessel Occlusions Undergoing Thrombectomy Using Single-Plane Versus...

Area of Science:

• Neurology
• Interventional Radiology
• Medical Devices

Background:

• Mechanical thrombectomy (MT) access is limited, with significant disparities in availability.
• Biplane angiography is standard, but single-plane systems may offer a cost-effective alternative.
• This study compares outcomes of MT performed with single-plane versus biplane angiography.

Purpose of the Study:

• To compare procedural and clinical outcomes of mechanical thrombectomy (MT) using single-plane versus biplane angiography suites.
• To assess the viability of single-plane systems as an alternative to biplane systems for stroke treatment.

Main Methods:

• A propensity-matched analysis of consecutive stroke MT cases from 2018-2024 across 3 centers (2 single-plane, 1 biplane).
• Outcomes included first-pass effect, successful reperfusion, time to reperfusion, complication rates, symptomatic intracranial hemorrhage, and functional outcome (modified Rankin Scale).

Main Results:

• After propensity matching (50 patients per group), no significant differences were found in successful reperfusion or good clinical outcome at 90 days between single-plane and biplane groups.
• Multivariable analysis showed no association between angiography suite type and reperfusion or clinical outcomes.
• Unmatched analysis also revealed no significant differences in reperfusion rates or clinical outcomes.

Conclusions:

• Single-plane angiography suites are a viable alternative for MT of proximal large-vessel occlusions in the anterior circulation.
• These findings are particularly relevant for areas where establishing a full biplane suite is not feasible.
• No statistically significant differences in procedural, clinical, or safety outcomes were observed between single-plane and biplane systems.