TY - JOUR T1 - Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 979 LP - 983 DO - 10.1136/neurintsurg-2018-014696 VL - 11 IS - 10 AU - Dong-Hun Kang AU - Jin Woo Kim AU - Byung Moon Kim AU - Ji Hoe Heo AU - Hyo Suk Nam AU - Young Dae Kim AU - Yang-Ha Hwang AU - Yong-Won Kim AU - Jang-Hyun Baek AU - Joonsang Yoo AU - Dong Joon Kim AU - Pyoung Jeon AU - Oh Young Bang AU - Seung Kug Baik AU - Sang Hyun Suh AU - Kyung-Yul Lee AU - Hyo Sung Kwak AU - Hong Gee Roh AU - Young-Jun Lee AU - Sang Heum Kim AU - Chang-Woo Ryu AU - Yon-Kwon Ihn AU - Byungjun Kim AU - Hong Jun Jeon AU - Jun Soo Byun AU - Sangil Suh AU - Jeong Jin Park AU - Jieun Roh Y1 - 2019/10/01 UR - http://jnis.bmj.com/content/11/10/979.abstract N2 - Backgroud The need for rescue treatment (RT) may differ depending on first-line modality (stent retriever (SR) or contact aspiration (CA)) in endovascular thrombectomy (EVT). We aimed to investigate whether the type of first-line modality in EVT was associated with the need for RT.Methods We identified all patients who underwent EVT for anterior circulation large-vessel occlusion from prospectively maintained registries of 17 stroke centers. Patients were dichotomized into SR-first and CA-first. RT involved switching to the other device, balloon angioplasty, permanent stenting, thrombolytics, glycoprotein IIb/IIIa antagonist, or any combination of these. We compared clinical characteristics, procedural details, and final recanalization rate between the two groups and assessed whether first-line modality type was associated with RT requirement and if this affected clinical outcome.Results A total of 955 patients underwent EVT using either SR-first (n=526) or CA-first (n=429). No difference occurred in the final recanalization rate between SR-first (82.1%) and CA-first (80.2%). However, recanalization with the first-line modality alone and first-pass recanalization rates were significantly higher in SR-first than in CA-first. CA-first had more device passes and higher RT rate. The RT group had significantly longer puncture-to-recanalization time (93±48 min versus 53±28 min). After adjustment, CA-first remained associated with RT (OR, 1.367; 95% CI, 1.019 to 1.834). RT was negatively associated with good outcome (OR, 0.597; 95% CI, 0.410 to 0.870).Conclusion CA was associated with requiring RT, while recanalization with first-line modality alone and first-pass recanalization rates were higher with SR. RT was negatively associated with good outcome. ER -