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Figures
- Fig 1.
A 72-year-old male patient who presented with weakness of the left limb for 4 hours. A, CT on admission does not show a large-territory infarct. B, CTA shows right MCA segment occlusion (arrow). C, DSA confirms occlusion of the right MCA segment (arrow). D, A microguidewire crosses the occluded artery. E, A microcatheter crosses the thrombus to the distal segment through the microguidewire. F, Angiogram after deployment of the Solitaire 6 × 30 mm stent retriever shows restoration immediately in the MCA. Arrows show proximal and distal markers of the Solitaire device. G, The stent retriever is unsheathed with the microcatheter being pulled back simultaneously (arrow). H, After 3 passes of thrombectomy, the final angiography shows a mTICI flow of grade 2B in the right MCA with favorable perfusion (arrow). I, CT postprocedure at 24 hours shows no obvious intracerebral hemorrhage. J, MRA postprocedure at 7 days shows good recanalization (arrow).
Tables
Before Matching P After Matching P ST 6 (n = 256) ST 4 (n = 372) ST 6 (n = 169) ST 4 (n = 169) Age (median) (IQR) (yr) 68 (58–75) 64 (53–73) .003 67 (56–75) 64 (53–73) .103 Women (No.) (%) 112 (43.8%) 150 (40.3%) .392 71 (42%) 64 (37.9%) .505 AF (No.) (%) 131 (51.2%) 138 (37.2%) .001 80 (47.3%) 67 (39.6%) .160 Hypertension (No.) (%) 158 (61.7%) 231 (62.1%) .924 112 (66.3%) 105 (62.1%) .500 Diabetes mellitus (No.) (%) 45 (17.6%) 66 (17.7%) .958 35 (20.7%) 29 (17.2%) .488 Current smoker (No.) (%) 69 (27%) 92 (24.7%) .531 49 (29%) 41 (24.3%) .389 SBP (median) (IQR) (mm Hg) 145 (130–161) 144 (130–160) .537 148 (129–163) 148 (130–160) .393 GLU (median) (IQR) (mmol/L) 6.9 (5.83–8.9) 6.7 (5.77–8.38) .173 6.83 (5.6–9.25) 6.9 (5.81–8.69) 1.000 ASPECTS (median) (IQR) 9 (7–10) 9 (8–10) .001 9 (7–10) 9 (8–10) .784 NIHSS (median) (IQR) 17 (13–21) 16 (12–20) .029 17 (13–21) 17 (13–21) 1.000 IV (No.) (%) 81 (31.6%) 119 (32%) .927 56 (33.1%) 61 (36.1%) .657 Time from onset to visit (median) (IQR) (min) 130 (75–230) 120 (60–214) .058 138 (64–224) 120 (58–214) .316 Time from onset to puncture (median) (IQR) (min) 280 (210–350) 270 (205–347) .692 279 (202–345) 270 (195–346) .589 Stroke subtype Atherosclerotic (No.) (%) 95 (37.1%) 171 (46%) .027 68 (40.2%) 73 (43.2%) .644 Cardiac embolism (No.) (%) 146 (57%) 177 (47.5%) .02 90 (53.3%) 85 (50.3%) .657 Undetermined etiology (No.) (%) 15 (5.9%) 24 (6.5%) .763 11 (6.5%) 11 (6.5%) 1.000 Artery occlusion site ICA (No.) (%) 155 (60.5%) 86 (23.1%) <.001 78 (46.2%) 76 (45%) .791 MCA (No.) (%) 100 (39.1%) 284 (76.3%) <.001 90 (53.3%) 93 (55%) .607 ACA (No.) (%) 1 (0.4%) 2 (0.5%) 1.000 1 (0.6%) 0 1.000 Collateral flow grade (ASITN/SIR) <.001 .261 0–1 (No.) (%) 156 (61.2%) 156 (42.2%) 93 (55%) 83 (49.1%) 2–3 (No.) (%) 99 (38.8%) 214 (57.8%) 76 (45%) 86 (50.9%) Note:—ASITN/SIR indicates American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology; AF, atrial fibrillation; GLU, glucose; ACA, anterior cerebral artery; SBP, systolic blood pressure.
↵a The logistic regression model used for the determination of the propensity score included the following factors: age, sex, atrial fibrillation, hypertension, diabetes, time from onset to groin puncture, NIHSS score, ASPECTS, stroke subtype, site of vessel occlusion, and collateral blood flow.
Before Matching P After Matching P ST 6 (n = 256) ST 4 (n = 372) ST 6 (n = 169) ST 4 (n = 169) mTICI .013 .532 0–2a (No.) (%) 51 (19.9%) 47 (12.6%) 31 (18.3%) 26 (15.4%) 2b–3 (No.) (%) 205 (80.1%) 325 (87.4%) 138 (81.7%) 143 (84.6%) Workflow time Time from puncture to reperfusion (median) (IQR) (min) 111.5 (80–153) 97 (72–140) .007 108 (75–147) 100 (75–156) 1.000 Time from stent deployment to reperfusion (median) (IQR) (min) 61 (30–94) 44 (20–75) <.001 58 (30–87) 45 (21–82) .021 Passes (median) (IQR) 2 (1–3) 2 (1–3) .001 2 (1–3) 2 (1–3) .375 ≤3 (No.) (%) 210 (82%) 323 (86.8%) .099 106 (62.7%) 119 (70.4%) .154 Rescue therapy (No.) (%) 134 (52.3%) 184 (49.5%) .478 85 (50.3%) 84 (49.7%) 1.000 Complications Vessel dissection (No.) (%) 3 (1.2%) 6 (1.6%) .744 2 (1.2%) 5 (3.0%) .453 Arterial perforation (No.) (%) 2 (0.8%) 6 (1.6%) .482 2 (1.2%) 2 (1.2%) 1.000 Stent failure to deploy (No.) (%) 1 (0.4%) 0 .408 1 (0.6%) 0 1.000 Isolated SAH (No.) (%) 4 (1.6%) 9 (2.4%) .459 3 (1.8%) 1 (0.6%) .625 Symptomatic ICH (No.) (%) 41 (16%) 60 (16.1%) .970 22 (13%) 27 (16%) .511 Asymptomatic ICH (No.) (%) 92 (35.9%) 118 (31.7%) .271 56 (33.1%) 67 (39.6%) .248 mRS 90 days .003 .087 0–2 (No.) (%) 89 (34.8%) 173 (46.5%) 64 (37.9%) 79 (46.7%) 3–6 (No.) (%) 167 (65.2%) 199 (53.5%) 105 (62.1%) 90 (53.3%) In-hospital mortality (No.) (%) 74 (28.9%) 78 (21%) .022 38 (22.5%) 39 (23.1%) 1.000 Note:—ICH indicates intracerebral hemorrhage.
- Table 3:
Baseline characteristics of atherosclerotic-related occlusion before and after matchinga
Before Matching P After Matching P ST 6 (n = 95) ST 4 (n = 171) ST 6 (n = 66) ST 4 (n = 66) Age (mean) (SD) (yr) 65 (11) 63 (13) .086 64 (11.4) 62 (11.7) .249 Women (No.) (%) 28 (29.5%) 47 (27.5%) .730 16 (24.2%) 16 (24.2%) 1.000 Hypertension (No.) (%) 65 (68.4%) 115 (67.3%) .845 48 (72.7%) 42 (63.6%) .307 Diabetes mellitus (No.) (%) 21 (22.1%) 30 (17.5%) .365 16 (24.2%) 7 (10.6%) .078 Current smoker (No.) (%) 34 (35.8%) 56 (32.7%) .615 25 (37.9%) 25 (37.9%) 1.000 SBP (median) (IQR) (mm Hg) 148 (135–163) 147 (130–160) .351 148 (135–162) 140 (129–160) .268 GLU (median) (IQR) (mmol/L) 6.54 (5.46–9.00) 6.70 (5.68–8.32) .812 6.41 (5.2–8.95) 6.62 (5.7–8.34) .538 ASPECTS (median) (IQR) 9 (7–10) 9 (8–10) .012 9 (8–10) 10 (8–10) .233 NIHSS (median) (IQR) 16 (12–20) 16 (11–19) .154 16 (12–19) 16 (11–19) .873 IV (No.) (%) 30 (31.6%) 61 (35.7%) .500 25 (37.9%) 24 (36.4%) 1.000 Time from onset to visit (median) (IQR) (min) 153 (90–232) 120 (60–216) .032 152 (90–220) 122 (49–242) .450 Time from onset to treatment (median) (IQR) (min) 293 (225–364) 280 (210–356) .352 289 (224–351) 275 (206–355) .532 Artery occlusion site ICA (No.) (%) 55 (57.9%) 33 (19.3%) <.001 32 (48.5%) 29 (43.9%) .375 MCA (No.) (%) 39 (41.1%) 136 (79.5%) <.001 33 (50%) 36 (54.5%) .375 ACA (No.) (%) 1 (1.1%) 2 (1.2%) .931 1 (1.5%) 1 (1.5%) 1.000 Collateral flow grade (ASITN/SIR) .023 1.000 0–1 (No.) (%) 50 (52.6%) 65 (38.2%) 32 (48.5%) 31 (47%) 2–3 (No.) (%) 45 (47.4%) 105 (61.8%) 99 (51.5%) 214 (53%) Note:—ASITN/SIR indicates American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology; GLU, glucose; ACA, anterior cerebral artery; SBP, systolic blood pressure.
↵a The logistic regression model used for the determination of the propensity score included the following factors: age, time from onset symptom to visit, time from onset to groin puncture, NIHSS score, ASPECTS, site of vessel occlusion, and collateral blood flow.
Before Matching P After Matching P ST 6 (n = 95) ST 4 (n = 171) ST 6 (n = 66) ST 4 (n = 66) mTICI .012 .021 0–2a (No.) (%) 20 (21.1%) 17 (9.9%) 16 (24.2%) 6 (9.1%) 2b–3 (No.) (%) 75 (78.9%) 154 (90.1%) 50 (75.8%) 60 (90.9%) Workflow time Time from puncture to reperfusion (median) (IQR) (min) 125 (90–180) 103 (75–145) .001 120 (89–170) 95 (65–136) .013 Time from stent deployment to reperfusion (median) (IQR) (min) 69 (32–117) 45 (23.5–79) .001 67 (33–114) 46 (19–68) .002 Passes (median) (IQR) 2 (1–3) 2 (1–2) .042 2 (1–3) 1 (1–2) .025 ≤3 (No.) (%) 75 (78.9%) 151 (88.3%) .041 51 (77.3%) 60 (90.9%) .064 Rescue therapy (No.) (%) 68 (71.6%) 99 (57.9%) .027 47 (71.2%) 38 (57.6%) .164 Complications Arterial perforation (No.) (%) 0 4 (2.3%) .300 0 2 (3.0%) .500 Vessel dissection (No.) (%) 1 (1.1%) 2 (1.2%) 1.000 0 2 (3.0%) .500 Stent failure to deploy (No.) (%) 1 (1.1%) 0 .357 1 (1.5%) 0 1.000 Isolated SAH (No.) (%) 0 6 (3.5%) .092 0 1 (1.5%) 1.000 Symptomatic ICH (No.) (%) 13 (13.7%) 18 (10.5%) .442 6 (9.1%) 4 (6.1%) .754 Asymptomatic ICH (No.) (%) 29 (30.5%) 52 (30.4%) .984 19 (28.8%) 24 (36.4%) .405 mRS 90 days .032 .486 0–2 (No.) (%) 37 (38.9%) 90 (52.6%) 28 (42.4%) 33 (50%) 3–6 (No.) (%) 58 (61.1%) 81 (47.4%) 38 (57.6%) 33 (50%) In-hospital mortality (No.) (%) 19 (20%) 29 (17%) .537 13 (19.7%) 15 (22.7%) .832 Note:—ICH indicates intracerebral hemorrhage.
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