{
  "abstract": "Background The contact aspiration (CA) technique is often used to perform endovascular thrombectomy (EVT) for acute ischemic stroke (AIS); however, rescue strategies are necessary if CA fails to achieve recanalization. This study investigates the outcomes of incorporating stent retriever (SR) thrombectomy in the rescue strategy following failed CA.Methods EVT patients with failed CA attempts were identified from a large multicenter registry and stratified by rescue technique: CA alone or incorporating SR in the rescue strategy. Outcomes included successful recanalization, 90-day functional outcomes (defined by the modified Rankin Scale (mRS) score), symptomatic intracranial hemorrhage (sICH), and 90-day mortality.Results Among 1885 patients with failed CA attempts, conversion to SR was associated with higher recanalization rates (85.2% vs 80.6%; p=0.03), higher rates of second-pass recanalization (31.2% vs 23.4%; p<0.001), and better 90-day outcomes (mRS 0–2: 35.2% vs 29.9%; p=0.04) when compared with repeated CA attempts. Trevo SRs showed higher odds of successful recanalization (adjusted odds ratio (aOR)=1.9; p=0.02), second-pass recanalization (aOR=1.7; p=0.01), and reduced odds of sICH (aOR=0.3; p=0.02). EmboTrap SRs were associated with higher odds of 90-day mortality (aOR=2.6; p=0.004) and sICH (aOR=2.9; p=0.04) and lower odds of recanalization (aOR=0.5; p=0.03).Conclusions Incorporating SR in the rescue strategy after a failed CA improves recanalization rates and functional outcomes. Trevo SRs demonstrated superior efficacy and safety when incorporated into the rescue strategy.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Sciences, College of Medicine, University of Houston, Houston, Texas, USA",
        "Neuroendovascular Surgery, HCA Houston Healthcare, Houston, Texas, USA"
      ],
      "name": "Mohamad Ezzeldin"
    },
    {
      "affiliations": [
        "Medicine, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA"
      ],
      "name": "Mishaal Hukamdad"
    },
    {
      "affiliations": [
        "Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Rahim Abo Kasem"
    },
    {
      "affiliations": [
        "Medicine, Jordan University of Science and Technology Faculty of Medicine, Irbid, Jordan"
      ],
      "name": "Rime Ezzeldin"
    },
    {
      "affiliations": [
        "Neurology, University Medicine Goettingen, Goettingen, Germany"
      ],
      "name": "Ilko Maier"
    },
    {
      "affiliations": [
        "Neuroradiology, West Virginia University, Morgantown, West Virginia, USA"
      ],
      "name": "Ansaar T Rai"
    },
    {
      "affiliations": [
        "Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Pascal Jabbour"
    },
    {
      "affiliations": [
        "Neurology, Chonnam National University Hospital, Gwangju, Korea (the Republic of)"
      ],
      "name": "Joon-Tae Kim"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Brian M Howard"
    },
    {
      "affiliations": [
        "Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Ali Alawieh"
    },
    {
      "affiliations": [
        "Neurosurgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA"
      ],
      "name": "Stacey Q Wolfe"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Robert M Starke"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Marios-Nikos Psychogios"
    },
    {
      "affiliations": [
        "Neurology, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"
      ],
      "name": "Amir Shaban"
    },
    {
      "affiliations": [
        "Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA"
      ],
      "name": "Nitin Goyal"
    },
    {
      "affiliations": [
        "Neurosurgery, Loma Linda University Health, Loma Linda, California, USA"
      ],
      "name": "Justin Dye"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA"
      ],
      "name": "Ali Alaraj"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan"
      ],
      "name": "Shinichi Yoshimura"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The State University of New York at Stony Brook (SUNY SB), New York, New York, USA"
      ],
      "name": "David Fiorella"
    },
    {
      "affiliations": [
        "Neurosurgery, Baylor College of Medicine, Houston, Texas, USA"
      ],
      "name": "Omar Tanweer"
    },
    {
      "affiliations": [
        "Neuroradiology, University Hospital 'San Giovanni di Dio e Ruggi d’Aragona', Salerno, Italy"
      ],
      "name": "Daniele G Romano"
    },
    {
      "affiliations": [
        "Interventional and Diagnostic Neuroradiology, Hospital Universitario La Paz, Madrid, Spain"
      ],
      "name": "Pedro Navia"
    },
    {
      "affiliations": [
        "Neurosurgery, Louisiana State University Health Sciences Center (LSUHSC), Shreveport, Louisiana, USA"
      ],
      "name": "Hugo Cuellar"
    },
    {
      "affiliations": [
        "Neuroradiology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal"
      ],
      "name": "Isabel Fragata"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Florida, Gainesville, Florida, USA"
      ],
      "name": "Adam Polifka"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Texas Health and Science Center at San Antonio, San Antonio, Texas, USA"
      ],
      "name": "Justin R Mascitelli"
    },
    {
      "affiliations": [
        "Neurosurgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA"
      ],
      "name": "Joshua W Osbun"
    },
    {
      "affiliations": [
        "Neurology, University of Michigan Health-West, Wyoming, Michigan, USA"
      ],
      "name": "Fazeel Siddiqui"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Washington Regional Medical Center, Fayetteville, Arkansas, USA"
      ],
      "name": "Mark Moss"
    },
    {
      "affiliations": [
        "Neurology, Indiana University, Bloomington, Indiana, USA"
      ],
      "name": "Kaustubh Limaye"
    },
    {
      "affiliations": [
        "Neurosurgery, University of South Florida College of Medicine, Tampa, Florida, USA"
      ],
      "name": "Maxim Mokin"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale University, New Haven, Connecticut, USA"
      ],
      "name": "Charles Matouk"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Virginia, Charlottesville, Virginia, USA"
      ],
      "name": "Min S Park"
    },
    {
      "affiliations": [
        "Neuroradiology, Mayo Clinic Minnesota, Rochester, Minnesota, USA"
      ],
      "name": "Waleed Brinjikji"
    },
    {
      "affiliations": [
        "Neurosurgery, Ankara Bilkent City Hospital, Ankara, Turkey"
      ],
      "name": "Ergun Daglioglu"
    },
    {
      "affiliations": [
        "Neurology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Richard Williamson"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Montefiore Medical Center, Bronx, New York, USA"
      ],
      "name": "David J Altschul"
    },
    {
      "affiliations": [
        "Neurosurgery, Beth Israel Deaconess Medical Center (BIDMC), Boston, Massachusetts, USA"
      ],
      "name": "Christopher S Ogilvy"
    },
    {
      "affiliations": [
        "Endovascular Neurosurgery, Médica Uruguaya, Montevideo, Uruguay"
      ],
      "name": "Roberto Javier Crosa"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA"
      ],
      "name": "Michael R Levitt"
    },
    {
      "affiliations": [
        "Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France"
      ],
      "name": "Benjamin Gory"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah, USA"
      ],
      "name": "Ramesh Grandhi"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Albany Medical College, Albany, New York, USA"
      ],
      "name": "Alexandra R Paul"
    },
    {
      "affiliations": [
        "Neurosurgery, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA"
      ],
      "name": "Peter Kan"
    },
    {
      "affiliations": [
        "Neurosurgery, Hospital Juan A. Fernandez, Buenos Aires, Argentina"
      ],
      "name": "Walter Casagrande"
    },
    {
      "affiliations": [
        "Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, USA"
      ],
      "name": "Shakeel A Chowdhry"
    },
    {
      "affiliations": [
        "Vascular Neurosurgery, Piedmont Healthcare Inc, Atlanta, Georgia, USA"
      ],
      "name": "Michael F Stiefel"
    },
    {
      "affiliations": [
        "Neuroendovascular Surgery, HCA Houston Healthcare Kingwood, Kingwood, Texas, USA"
      ],
      "name": "Varun Chaubal"
    },
    {
      "affiliations": [
        "Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Alejandro M Spiotta"
    }
  ],
  "title": "Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy",
  "uid": "51f063b9-e6aa-56f5-b747-360fdaff3c36"
}