{
  "abstract": "Background Although mechanical thrombectomy (MT) is an effective treatment for large vessel occlusion (LVO) with a high successful recanalization rate, MT failure (MTF) occurs in 10–15% of cases and is associated with unfavorable outcomes. However, little is known about the clinical, technical, and radiological reasons for MTF. We investigated the technical factors associated with MTF.Methods We conducted a retrospective analysis of consecutive patients with anterior LVO prospectively included in the ongoing observational multicenter ROSSETTI registry. Patients were categorized according to the success (≥mTICI 2b) or failure (<mTICI 2b) of the MT procedure. Baseline clinical and demographic characteristics, endovascular MT techniques, and angiographic and clinical outcomes were compared. Multivariate analysis for prediction of MTF was performed.Results We analyzed 4135 patients, including 325 patients (7.9%) with MTF. Patients in the MTF group had a significantly lower Alberta Stroke Program Early CT Score (ASPECTS) at baseline (8 (7–10) vs 9 (8–10)), longer time since last time seen well (279 min vs 262 min), increased MT procedure time (76 min vs 31 min), higher rate of complications (23% vs 4%), higher symptomatic intracerebral hemorrhage (21% vs 7.9%), higher 24 hour National Institutes of Health Stroke Scale score (19 vs 6), worse functional outcome at 3 months (modified Rankin Scale score 0–2, 15.6% vs 53%), and higher mortality (45% vs 20%). Four or more passes were an independent predictor of MTF (OR 3.46, 95% CI 2.58 to 4.63; P<0.001). None of the endovascular techniques demonstrated a higher likelihood of MTF.Conclusion In this study, MTF in anterior circulation LVO was associated with a high complication rate and worse outcomes.",
  "authors": [
    {
      "affiliations": [
        "Interventional Neurorradiology, La Fe University and Polytechnic Hospital, Valencia, Spain"
      ],
      "name": "Lluis Morales-Caba"
    },
    {
      "affiliations": [
        "Radiology Department CDI and IDIBAPS, Hospital Clinic de Barcelona, Barcelona, Spain"
      ],
      "name": "Josep Puig"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain"
      ],
      "name": "Juan Manuel Sanchís"
    },
    {
      "affiliations": [
        "La Fe University and Polytechnic Hospital, Valencia, Spain"
      ],
      "name": "Víctor Vázquez"
    },
    {
      "affiliations": [
        "Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain"
      ],
      "name": "Mariano Werner"
    },
    {
      "affiliations": [
        "Neurointerventional Department CDI, Hospital Clinic de Barcelona, Barcelona, Spain"
      ],
      "name": "Guillem Dolz"
    },
    {
      "affiliations": [
        "Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain"
      ],
      "name": "Marc Comas-Cufí"
    },
    {
      "affiliations": [
        "Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain"
      ],
      "name": "Pepus Daunis-i-Estadella"
    },
    {
      "affiliations": [
        "Radiology, Hospital Universitario Central de Asturias, Oviedo, Spain"
      ],
      "name": "Pedro Vega"
    },
    {
      "affiliations": [
        "Radiology, Hospital Universitario Central de Asturias, Oviedo, Spain"
      ],
      "name": "Eduardo Murias"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology. Radiology, Hospital Universitario Cruces, Bilbao, Spain"
      ],
      "name": "Eva González"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology. Radiology, Hospital Universitario Cruces, Bilbao, Spain"
      ],
      "name": "Xabier Manso"
    },
    {
      "affiliations": [
        "Diagnostic and Therapeutical Neuroradiology Unit, Hospital Reina Sofía, Córdoba, Spain"
      ],
      "name": "Fernando Delgado"
    },
    {
      "affiliations": [
        "Neurorradiology, Hospital Universitario Reina Sofia, Cordoba, Spain"
      ],
      "name": "Carlos Martínez"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Clinico Universitario San Carlos, Madrid, Spain"
      ],
      "name": "Carlos Pérez-García"
    },
    {
      "affiliations": [
        "Department of Radiology, Clinical San Carlos Hospital, Section of Interventional Neuroradiology, Madrid, Spain"
      ],
      "name": "Santiago Rosati"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Spain",
        "Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Spain"
      ],
      "name": "Sebastian Remollo"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain"
      ],
      "name": "Carlos Castaño"
    },
    {
      "affiliations": [
        "Stroke Unit, Department of Neurology, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain"
      ],
      "name": "Isabel Vielba-Gómez"
    },
    {
      "affiliations": [
        "Stroke Unit, Department of Neurology, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain"
      ],
      "name": "Tomàs Xuclà"
    },
    {
      "affiliations": [
        "Neuroradiology, Hospital Universitari de Bellvitge, Barcelona, Spain"
      ],
      "name": "Lucia Aja"
    },
    {
      "affiliations": [
        "Department of Radiology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain"
      ],
      "name": "Javier Martínez-Fernández"
    },
    {
      "affiliations": [
        "Radiology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain"
      ],
      "name": "Yeray Aguilar Tejedor"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology Unit, Radiology, Hospital Ramón y Cajal, Madrid, Spain"
      ],
      "name": "Jose Carlos Mendez"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Alicante General University Hospital, Alicante, Valenciana, Spain"
      ],
      "name": "José Carlos Rayón-Aledo"
    },
    {
      "affiliations": [
        "Hospital Universitario Virgen de la Arrixaca, Murcia, Spain"
      ],
      "name": "Guillermo Parrilla"
    },
    {
      "affiliations": [
        "Radiology, Bellvitge University Hospital, Barcelona, Spain",
        "Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain"
      ],
      "name": "Víctor Cuba"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Hospital Universitario de Salamanca, Salamanca, Spain"
      ],
      "name": "Luis Hernán Vargas"
    },
    {
      "affiliations": [
        "Stroke Unit, Neurology, Hospital Clinic de Barcelona, Barcelona, Spain"
      ],
      "name": "Antonio Doncel-Moriano Cubero"
    },
    {
      "affiliations": [
        "Neurointerventional Department CDI, Hospital Clinic de Barcelona, Barcelona, Spain"
      ],
      "name": "Luis San Roman"
    },
    {
      "affiliations": [
        "Neurointerventional Department CDI, Hospital Clinic de Barcelona, Barcelona, Spain"
      ],
      "name": "Jordi Blasco"
    },
    {
      "affiliations": [
        "Sección Neurorradiología, Area Clinica, Imagen Médica, Hospital Politécnico y Universitario La Fe, Valencia, Spain"
      ],
      "name": "Fernando Aparici-Robles"
    }
  ],
  "title": "Mechanical thrombectomy failure in anterior circulation large vessel occlusion: an overview from the ROSSETTI registry",
  "uid": "7f256d45-47e3-5046-8815-73c6696cf0a9"
}