The impact of thrombus surface morphology of the basilar artery on the successful rate of mechanical thrombectomy

Authors

Xinzhao Jiang, Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Shufeng Yu, Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
David Wang, Department of Neurology, Barrow Neurological Institute (BNI), Phoenix, AZ, United States.Follow
Y I. Dong, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China.
Peng Wang, Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.

Document Type

Article

Abstract

OBJECTIVE: The present study aimed to investigate the impact of angiographic thrombus surface morphology on the angiographic and clinical outcomes of basilar artery occlusion (BAO). METHODS: This retrospective study included 141 patients with acute BAO who underwent mechanical thrombectomy (MT). We categorized thrombus surface phenotypes as either regular (smooth and straight, either convex or concave) or irregular. Patients with BAO were grouped based on the presence of a regular or irregular phenotype, and we compared their angiographic and clinical outcomes. RESULTS: In total, 52.5% (74/141) of acute BAO patients exhibited a regular thrombus morphology. These patients had a higher rate of first-pass effect (28.4% vs. 4.5%,  = 0.0002) and fewer retrieval attempts (2 vs. 2;  = 0.0198) compared to those with irregular morphology. Among patients treated with contact aspiration (CA), the regular thrombus morphology showed a higher first-pass success rate (45.7% vs. 12.8%;  = 0.0017), a shorter procedural duration (46 vs. 50 min;  = 0.0159), and fewer retrieval attempts (1 vs. 2;  = 0.0338) compared to stent retriever (SR) thrombectomy. Both the regular thrombus morphology (OR 7.72, 95% CI 2.02-29.52;  = 0.003) and using CA as the first-line treatment (OR 3.37, 95% CI 1.12-10.13;  = 0.031) independently predicted first-pass success. CONCLUSION: For BAO patients treated with CA as the primary strategy, the presence of a regular thrombus surface might predict higher first-pass success and shorter procedural duration. A diligent assessment of thrombus morphology within the MT workflow could improve the feasibility of procedural techniques.

Publication Date

1-1-2023

Publication Title

Frontiers in neurology

ISSN

1664-2295

Volume

14

First Page

1280317

PubMed ID

38073657

Digital Object Identifier (DOI)

10.3389/fneur.2023.1280317

Recommended Citation

Jiang, Xinzhao; Yu, Shufeng; Wang, David; Dong, Y I.; and Wang, Peng, "The impact of thrombus surface morphology of the basilar artery on the successful rate of mechanical thrombectomy" (2023). Neurology. 1824.
https://scholar.barrowneuro.org/neurology/1824