Related Experiment Video
Updated: May 23, 2026
The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
Matched-Pair Analysis of Patients With Large-Vessel Occlusions Undergoing Thrombectomy Using Single-Plane Versus
Diwas Gautam1, Sarah E Nguyen2, Sarah Dabb2
1Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City (D.G., J.A., J.B.).
Background:
The Mechanical Thrombectomy Global Access for Stroke study demonstrated that access to mechanical thrombectomy (MT) is <3% of demand, with severe disparities across urbanization and income levels. Although biplane angiography is the standard, single-plane systems may offer a cost-effective alternative. We conducted a propensity-matched analysis comparing the procedural and clinical outcomes of MT performed in single-plane versus biplane angiography suites.
Methods:
All consecutive stroke MT cases performed at 3 centers (2 single plane and 1 biplane) between 2018 and 2024 were included. Outcomes assessed included rates of first-pass effect (modified Thrombolysis in Cerebral Infarction score ≥2b on first pass), successful reperfusion (final modified Thrombolysis in Cerebral Infarction score ≥2b), time to reperfusion, complication rates, postprocedural symptomatic intracranial hemorrhage, and good clinical outcome (modified Rankin Scale score 0-2) at discharge, 30 days, and 90 days.
Results:
A total of 51 thrombectomies were performed in single-plane suites, and 367 were performed in biplane suites. After propensity matching, 100 patients (50 in each group) were included. In a multivariable analysis, the type of angiography suite was not significantly associated with successful reperfusion (odds ratio, 3.84 [95% CI, 0.22-68.4]; P=0.36) or good clinical outcome at 90 days (odds ratio, 0.94 [95% CI, 0.18-4.88]; P=0.94). There were no significant differences in reperfusion rates and clinical outcomes in the unmatched comparison. In the unmatched cohort, higher numbers of patients with medium- or distal-vessel occlusions and posterior circulation strokes were treated in the biplane suite.
Conclusions:
This propensity score-matched analysis comparing MT for large-vessel occlusion in single-plane versus biplane angiography suites demonstrated no statistically significant differences in procedural and clinical outcomes or safety measures. These results indicate that MT using single-plane angiography suites can serve as a viable alternative for treating proximal large-vessel occlusions within the anterior circulation in areas where establishing a full biplane suite is not feasible.
