Introduction Technical success in endovascular thrombectomy (EVT) is one of the most important factors for favorable functional outcome in acute ischemic stroke (AIS). Several studies have addressed technical aspects of EVT, but it is not well known how procedural factors contribute to technical success in routine healthcare, especially factors that are not evaluated in trials, such as the time of the day or the day of the week.
Aim of Study The aim of this study was to explore factors associated with technically successful EVT on nationwide scale.
Methods We did an observational register-based study assessing factors associated with technical success on EVT in Sweden. The association between baseline and treatment variables and successful recanalization were explored using x2 test and univariate logistic regression. A multivariable logistic regression with a backwards conditional approach was used to define predictors of successful recanalization.
Results The study included 3211 patients treated with EVT for anterior circulation AIS during 2015–2020. Successful recanalization was achieved in 83.1% (2667) with a gradual improvement over the period.
Key findins include:
General anesthesia increases the technical success-rate from 81 (sedation) to 87%.
The success-rate is similar for tandem-lesions and for isolated intracranial occlusions.
The use of Balloon Guide Catheters increases the technical success-rate from 81 to 86%.
There is no significant drop in success-rate for low volume operators or centers.
The previous success-rate of the operator is the most discriminating factor for success.
Conclusion This study explore procedural factors associated with technically successful EVT on nationwide scale.
Disclosure of Interest JW received funding from the Crafoord Foundation (#20200548) The Swedish Government (YF-ALF #43435), Region of Skåne research grant (#47455), Skåne university Hospital research grants (#96437 and #96438), VINNOVA (#2020–04841) and AIDA (#2024). JW is a founder and shareholder in Uman Sense AB.
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