METHODS: We retrospectively analyzed the data of patients who underwent EVT caused by VBAO in a multicenter registry dataset. Patients who underwent successful reperfusion were included (mTICI 2b/3). Regression models were used to analyze the correlation of different reperfusion grades stratified by the number of retrieval attempts with clinical prognosis and hemorrhage transition.
RESULTS: We included 432 patients: 34.5% (n = 149) had a final mTICI score of 2b and 65.5% (n = 283) had a final mTICI score of 3. Patients who obtained a mTICI of 3 after the first pass had significantly increased odds of having a good prognosis. As the number of passes increases, the chances of obtaining a good prognosis decreases. After three or more passes, the odds of achieving functional independence and favorable outcomes were comparable to those of the first mTICI 2b, regardless of the 90-day (OR 1.132 95% CI 0.367-3.487 p = 0.829; OR 1.070 95% CI 0.375-3.047 p = 0.900) or 1-year follow-up (OR 1.217 95% CI 0.407-3.637 p = 0.725; OR 1.068 95% CI 0.359-3.173 p = 0.906).
CONCLUSIONS: Within two retrieval attempts, mTICI 3 was better than the first retrieval to mTICI 2b. After early mTICI 2b, each retrieval should be undertaken with caution to pursue a higher reperfusion grade.
方法:我们回顾性分析了在多中心登记数据集中接受VBAO引起的EVT患者的数据。纳入成功再灌注的患者(mTICI2b/3)。采用回归模型分析不同再灌注等级与临床预后和出血过渡的相关性。
结果:我们纳入了432例患者:34.5%(n=149)的mTICI最终评分为2b,65.5%(n=283)的mTICI最终评分为3。首次通过后mTICI为3的患者具有良好预后的几率显着增加。随着通过次数的增加,获得良好预后的机会减少.经过三次或更多次,实现功能独立性和有利结果的几率与第一批mTICI2b相当,无论90天(OR1.13295%CI0.367-3.487p=0.829;OR1.07095%CI0.375-3.047p=0.900)或1年随访(OR1.21795%CI0.407-3.637p=0.725;OR1.06895%CI0.359-3.173p=0.906)。
结论:在两次检索尝试中,mTICI3优于首次检索到mTICI2b。早期mTICI2b后,每次检索都应谨慎进行,以追求更高的再灌注等级.