TY - JOUR T1 - Comparison of aspiration versus combined technique as first-line approach in terminal internal carotid artery occlusion: a multicenter experience JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg DO - 10.1136/neurintsurg-2021-017585 SP - neurintsurg-2021-017585 AU - Francesco Diana AU - Sergio Lucio Vinci AU - Maria Ruggiero AU - Vittorio Semeraro AU - Sandra Bracco AU - Giulia Frauenfelder AU - Aldo Paolucci AU - Luigi Cirillo AU - Alessandro Pesce AU - Agostino Tessitore AU - Christian Commodaro AU - Maria Porzia Ganimede AU - Matteo Zanoni AU - Renato Saponiero AU - Andrea Zini AU - Mariano Velo AU - Beatrice Modello AU - Nicola Burdi AU - Samuele Cioni AU - Luigi Simonetti AU - Daniele Giuseppe Romano Y1 - 2021/08/03 UR - http://jnis.bmj.com/content/early/2021/08/03/neurintsurg-2021-017585.abstract N2 - Background There is no consensus on the most effective endovascular technique to use in patients with acute ischemic stroke due to terminal internal carotid artery (ICA) occlusion. The aim of this study was to compare safety and efficacy of the aspiration technique (AT) and combined technique (CT) as first-line approach in terminal ICA occlusions.Methods We performed a retrospective analysis of prospectively collected databases from seven Italian stroke centers. Patients were divided into two subgroups according to the first-line approach: AT group or CT group. We followed the STROBE guidelines for cohort studies. We used Chi-square test, one-way and multivariate ANOVA analysis, together with contrast analysis and post hoc tests, logistic regression and Pearson’s bivariate correlation for the statistical analyses.Results Between January 2018 and August 2020, 353 patients were treated for a terminal ICA occlusion, with either AT or CT. CT was associated with a higher Thrombolysis in Cerebral Infarction (TICI) 2B-3 after the first pass (51.0% vs 26.9%) and at the end of the procedure (84% vs 73.3%) and with an improved clinical outcome at discharge (modified Rankin Scale (mRs) 0–2 of 47.8% vs 34.0%) and at 3 months’ follow-up (mRs 0–2 of 56.5% vs 38.9%) compared with AT.Conclusion Thrombectomy of terminal ICA occlusions obtained using CT as first-line approach demonstrated better technical and functional outcomes in comparison with AT.The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. ER -