Higher degrees of recanalization after mechanical thrombectomy for acute stroke are associated with improved outcome and decreased mortality: Pooled analysis of the MERCI and multi MERCI trials

Jeremy D. Fields, Helmi Lutsep, W. S. Smith

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Abstract

BACKGROUND AND PURPOSE: Although the combined end point of partial and complete recanalization is a well-established predictor of good outcome following acute stroke intervention, few investigations have evaluated the effect of the degree of recanalization. We hypothesized that greater degrees of recanalization would be associated with a higher likelihood of favorable functional outcomes. MATERIALS AND METHODS: Data from MERCI and Multi MERCI-prospective single-arm trials of endovascular mechanical thrombectomy for acute stroke-were pooled. The TIMI score was used to define the degree of recanalization, and a favorable outcome was defined as an mRS score of 0-2 at 90 days. RESULTS: A total of 305 patients were included. Age, stroke severity, and site of arterial occlusion did not differ among groups stratified by the TIMI score. The unadjusted OR for a favorable outcome increased significantly as the TIMI score increased from 0 to 1 (OR, 5.9; 95% CI, 1.7-20.0; P = .007) and from 2 to 3 (OR. 2.3; 95% CI, 1.2- 4.5; P = .01) and the likelihood of death decreased significantly as the TIMI score increased from 2 to 3 (OR, 2.2; 95% CI, 1.1- 4.3; P = .05). In multivariate analysis, each increase in TIMI grade increased the odds of a good outcome 2.6-fold (95% CI, 1.9 -3.4, P

Original languageEnglish (US)
Pages (from-to)2170-2174
Number of pages5
JournalAmerican Journal of Neuroradiology
Volume32
Issue number11
DOIs
StatePublished - Dec 2011

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Thrombectomy
Stroke
Mortality
Multivariate Analysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Higher degrees of recanalization after mechanical thrombectomy for acute stroke are associated with improved outcome and decreased mortality: Pooled analysis of the MERCI and multi MERCI trials",
abstract = "BACKGROUND AND PURPOSE: Although the combined end point of partial and complete recanalization is a well-established predictor of good outcome following acute stroke intervention, few investigations have evaluated the effect of the degree of recanalization. We hypothesized that greater degrees of recanalization would be associated with a higher likelihood of favorable functional outcomes. MATERIALS AND METHODS: Data from MERCI and Multi MERCI-prospective single-arm trials of endovascular mechanical thrombectomy for acute stroke-were pooled. The TIMI score was used to define the degree of recanalization, and a favorable outcome was defined as an mRS score of 0-2 at 90 days. RESULTS: A total of 305 patients were included. Age, stroke severity, and site of arterial occlusion did not differ among groups stratified by the TIMI score. The unadjusted OR for a favorable outcome increased significantly as the TIMI score increased from 0 to 1 (OR, 5.9; 95{\%} CI, 1.7-20.0; P = .007) and from 2 to 3 (OR. 2.3; 95{\%} CI, 1.2- 4.5; P = .01) and the likelihood of death decreased significantly as the TIMI score increased from 2 to 3 (OR, 2.2; 95{\%} CI, 1.1- 4.3; P = .05). In multivariate analysis, each increase in TIMI grade increased the odds of a good outcome 2.6-fold (95{\%} CI, 1.9 -3.4, P",
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