TY - JOUR T1 - Clot perviousness is associated with first pass success of aspiration thrombectomy in the COMPASS trial JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 509 LP - 514 DO - 10.1136/neurintsurg-2020-016434 VL - 13 IS - 6 AU - Maxim Mokin AU - Muhammad Waqas AU - Johanna Fifi AU - Reade De Leacy AU - David Fiorella AU - Elad I Levy AU - Kenneth Snyder AU - Ricardo Hanel AU - Keith Woodward AU - Imran Chaudry AU - Ansaar T Rai AU - Donald Frei AU - Josser E Delgado Almandoz AU - Michael Kelly AU - Adam S Arthur AU - Blaise W Baxter AU - Joey English AU - Italo Linfante AU - Kyle M Fargen AU - Aquilla Turk AU - Adnan H Siddiqui AU - J Mocco Y1 - 2021/06/01 UR - http://jnis.bmj.com/content/13/6/509.abstract N2 - Background Clot density (Hounsfield units, HU) and perviousness (post-contrast increase in the HU of clot) are thought to be associated with clot composition. We evaluate whether these imaging characteristics were associated with angiographic outcomes of aspiration and stent retriever thrombectomy in COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion.Methods Clot density and perviousness were measured by two independent operators who were blind to all the final angiographic and clinical outcomes. The association of clot density and perviousness with the Thrombolysis In Cerebral Infarction (TICI) scale after first pass was assessed using univariate and multivariate analysis.Results Among all patients enrolled in COMPASS, 165 were eligible for the post-hoc analysis (81 patients in the aspiration first and 84 in the stent retriever first groups). Overall mean perviousness of clot was significantly higher in patient with mTICI 2b-3 after first pass (28.6±22.9 vs 20.3±19.2, p=0.017). Mean perviousness among patients who achieved TICI 2c/3 versus TICI 2b versus TICI 0-2a in the aspiration first group varied significantly (32.6±26.1, 35.3±24.4, and 17.7±13.1, p=0.013). The association of perviousness with first pass success was not significant in the stent retriever group. Using multivariate analysis, high perviousness (defined as cut-off >27.6) was an independent predictor of TICI 2b-3 (OR 3.82, 95% CI 1.10 to 13.19; p=0.034).Conclusions Clot perviousness is associated with first pass angiographic success in patients treated with the aspiration first approach for thrombectomy.Data are available upon reasonable request. Requests for data availability should be addressed to COMPASS principal investigators. ER -