Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointerventionF

Recanalization Rates Decrease with Increasing Thrombectomy Attempts

Y. Loh, R. Jahan, D.L. McArthur, Z.-S. Shi, N.R. Gonzalez, G.R. Duckwiler, P.M. Vespa, S. Starkman, J.L. Saver, S. Tateshima, D.S. Liebeskind and F. Viñuela
American Journal of Neuroradiology May 2010, 31 (5) 935-939; DOI: https://doi.org/10.3174/ajnr.A1958
Y. Loh
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
R. Jahan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
D.L. McArthur
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Z.-S. Shi
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
N.R. Gonzalez
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
G.R. Duckwiler
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
P.M. Vespa
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
S. Starkman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.L. Saver
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
S. Tateshima
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
D.S. Liebeskind
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
F. Viñuela
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Fig 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 1.

    Decision tree results at each of ≤6 retrieval attempts.

  • Fig 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 2.

    Graph shows the number of attempts used to achieve final outcome AOL score.

  • Fig 3.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 3.

    Graph shows aggregate odds that a given attempt number will recanalize.

  • Fig 4.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 4.

    Graph shows aggregate distribution of AOL scores following each attempt.

Tables

  • Figures
    • View popup
    Table 1:

    Comparison by final AOL score and optimal number of attempts

    DemographicFinal AOL ScorePValueOptimalSuboptimalPValue
    0–1 (n = 23)2–3 (n = 71)n = 61n= 33
    Age67.6 ± 18.365.0 ± 19.7.5865.4 ± 19.865.7 ± 18.6.94
    Male sex11 (47.8)30 (42.2).8225 (41.0)16 (48.5).52
    Prior history
        Hypertension11 (47.8)41 (57.7).5536 (59.0)16 (48.5).39
        Diabetes6 (26.1)12 (16.9).5112 (19.7)6 (18.2)1
        Dyslipidemia5 (21.7)22 (31.0).5619 (31.1)8 (24.2).63
        Peripheral vascular disease1 (4.3)1 (1.4).431 (1.6)1 (3.0)1
        Atrial fibrillation10 (43.5)36 (50.7).7232 (52.5)14 (42.4).39
    Time to pass6:43 ± 2:556:57 ± 2:55.747:02 ± 3:056:41 ± 2:38.60
    Intravenous thrombolytic6 (26.1)21 (29.6)119 (31.1)8 (24.2).63
    Intra-arterial thrombolytic3 (13.0)4 (5.6).363 (4.9)4 (12.1).24
    Total attempts, median (IQR)4 (2)2 (2)<.0001
    Complications9 (14.8)14 (42.4).006
        Subarachnoid hemorrhage6 (9.8)10 (30.3)
        Dissection1 (1.6)1 (3.0)
        Air embolism1 (1.6)2 (6.0)
        Device fracture2 (3.2)2 (6.0)
        Intraventricular hemorrhage02 (6.0)
        Perforation1 (1.6)0
    Parenchymal HT, 72 hoursa2 (13)11 (16)110 (19)3 (10)0.5
    • a Eleven patients were not included because they were not able to undergo imaging 72 hours after intervention; none of these patients had HT on post-Merci CT; 7 of these patients had a poor final-outcome AOL score, while 4 had good final-outcome AOL scores. Seven of these patients underwent the optimal number of attempts, while 4 did not.

    • View popup
    Table 2:

    Distribution of final outcome AOL scores by number of attempts

    AttemptFinal Outcome AOL Score, No. (%)
    0123
    101 (3)9 (24)28 (74)
    2005 (25)15 (75)
    39 (30)3 (10)12 (40)6 (20)
    45 (36)2 (14)2 (14)5 (36)
    53 (50)1 (17)1 (17)1 (17)
    65 (71)1 (14)01 (14)
    Total22 (19)8 (7)29 (25)56 (49)
    • View popup
    Table 3:

    Probability next attempt will improve existing recanalization result after a given number of attempts

    Next AttemptGood AOL Score, No. (%), after95% CI
    Next Attempt #Current AttemptOR
    37 (32.2)10InfiniteInfinite
    57 (49.6)237 (32.2)2.061.21–3.55
    75 (65.2)357 (49.6)1.901.12–3.25
    82 (71.3)475 (65.2)1.320.76–2.32
    84 (73.0)582 (71.3)1.090.61–1.95
    • View popup
    Table 4:

    Probability that the maximum number of attempts (6) will produce a final AOL result superior to a prospective prespecified number of attempts

    Good AOL Score, No. (%), after Attempting Up to:
    Six AttemptsPre-Specified NumberOR95% CI
    685 (73.9)137 (32.2)5.973.37–10.58
    685 (73.9)257 (49.6)2.881.66–5.02
    685 (73.9)375 (65.2)1.510.86–2.66
    685 (73.9)482 (71.3)1.140.64–2.04
    685 (73.9)584 (73.0)1.050.58–1.88
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 31 (5)
American Journal of Neuroradiology
Vol. 31, Issue 5
1 May 2010
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Recanalization Rates Decrease with Increasing Thrombectomy Attempts
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
Y. Loh, R. Jahan, D.L. McArthur, Z.-S. Shi, N.R. Gonzalez, G.R. Duckwiler, P.M. Vespa, S. Starkman, J.L. Saver, S. Tateshima, D.S. Liebeskind, F. Viñuela
Recanalization Rates Decrease with Increasing Thrombectomy Attempts
American Journal of Neuroradiology May 2010, 31 (5) 935-939; DOI: 10.3174/ajnr.A1958

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
Recanalization Rates Decrease with Increasing Thrombectomy Attempts
Y. Loh, R. Jahan, D.L. McArthur, Z.-S. Shi, N.R. Gonzalez, G.R. Duckwiler, P.M. Vespa, S. Starkman, J.L. Saver, S. Tateshima, D.S. Liebeskind, F. Viñuela
American Journal of Neuroradiology May 2010, 31 (5) 935-939; DOI: 10.3174/ajnr.A1958
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Abstract
    • Abbreviations
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Predictors of distal embolization during thrombectomy for anterior circulation large vessel bifurcation occlusion stroke
  • Bifurcation occlusions and endovascular treatment outcome in acute ischemic stroke
  • Impact of Repeated Clot Retrieval Attempts on Infarct Growth and Outcome After Ischemic Stroke
  • Systematic review and meta-analysis of current rates of first pass effect by thrombectomy technique and associations with clinical outcomes
  • More than three passes of stent retriever is an independent predictor of parenchymal hematoma in acute ischemic stroke
  • Effect of Retrievable Stent Size on Endovascular Treatment of Acute Ischemic Stroke: A Multicenter Study
  • Proximal to distal approach in the treatment of tandem occlusions causing an acute stroke
  • The golden hour of stroke intervention: effect of thrombectomy procedural time in acute ischemic stroke on outcome
  • Higher Degrees of Recanalization after Mechanical Thrombectomy for Acute Stroke Are Associated with Improved Outcome and Decreased Mortality: Pooled Analysis of the MERCI and Multi MERCI Trials
  • Predictors of Subarachnoid Hemorrhage in Acute Ischemic Stroke With Endovascular Therapy
  • Crossref (48)
  • Google Scholar

This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.

  • Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trial
    Raul G Nogueira, Helmi L Lutsep, Rishi Gupta, Tudor G Jovin, Gregory W Albers, Gary A Walker, David S Liebeskind, Wade S Smith
    The Lancet 2012 380 9849
  • More than three passes of stent retriever is an independent predictor of parenchymal hematoma in acute ischemic stroke
    Romain Bourcier, Suzana Saleme, Julien Labreuche, Mikael Mazighi, Robert Fahed, Raphael Blanc, Benjamin Gory, Maeva Kyheng, Gaultier Marnat, Serge Bracard, Hubert Desal, Arturo Consoli, Michel Piotin, Bertrand Lapergue
    Journal of NeuroInterventional Surgery 2019 11 7
  • The golden hour of stroke intervention: effect of thrombectomy procedural time in acute ischemic stroke on outcome
    Alejandro M Spiotta, Jan Vargas, Raymond Turner, M Imran Chaudry, Holly Battenhouse, Aquilla S Turk
    Journal of NeuroInterventional Surgery 2014 6 7
  • Recanalization Rate per Retrieval Attempt in Mechanical Thrombectomy for Acute Ischemic Stroke
    Fabian Flottmann, Hannes Leischner, Gabriel Broocks, Jawed Nawabi, Martina Bernhardt, Tobias Djamsched Faizy, Milani Deb-Chatterji, Götz Thomalla, Jens Fiehler, Caspar Brekenfeld
    Stroke 2018 49 10
  • Clot-Based Radiomics Predict a Mechanical Thrombectomy Strategy for Successful Recanalization in Acute Ischemic Stroke
    Jeremy Hofmeister, Gianmarco Bernava, Andrea Rosi, Maria Isabel Vargas, Emmanuel Carrera, Xavier Montet, Simon Burgermeister, Pierre-Alexandre Poletti, Alexandra Platon, Karl-Olof Lovblad, Paolo Machi
    Stroke 2020 51 8
  • Identifying the predictors of first-pass effect and its influence on clinical outcome in the setting of endovascular thrombectomy for acute ischemic stroke: Results from a multicentric prospective registry
    Federico Di Maria, Maéva Kyheng, Arturo Consoli, Jean-Philippe Desilles, Benjamin Gory, Sébastien Richard, Georges Rodesch, Julien Labreuche, Jean-Baptiste Girot, Cyril Dargazanli, Gaultier Marnat, Bertrand Lapergue, Romain Bourcier
    International Journal of Stroke 2021 16 1
  • Systematic review and meta-analysis of current rates of first pass effect by thrombectomy technique and associations with clinical outcomes
    Mehdi Abbasi, Yang Liu, Seán Fitzgerald, Oana Madalina Mereuta, Jorge L Arturo Larco, Asim Rizvi, Ramanathan Kadirvel, Luis Savastano, Waleed Brinjikji, David F Kallmes
    Journal of NeuroInterventional Surgery 2021 13 3
  • Predictors of Subarachnoid Hemorrhage in Acute Ischemic Stroke With Endovascular Therapy
    Zhong-Song Shi, David S. Liebeskind, Yince Loh, Jeffrey L. Saver, Sidney Starkman, Paul M. Vespa, Nestor R. Gonzalez, Satoshi Tateshima, Reza Jahan, Lei Feng, Chad Miller, Latisha K. Ali, Bruce Ovbiagele, Doojin Kim, Gary R. Duckwiler, Fernando Viñuela
    Stroke 2010 41 12
  • Neurothrombectomy Devices for the Treatment of Acute Ischemic Stroke: State of the Evidence
    William L. Baker, Jennifer A. Colby, Vanita Tongbram, Ripple Talati, Isaac E. Silverman, C. Michael White, Jeffrey Kluger, Craig I. Coleman
    Annals of Internal Medicine 2011 154 4
  • SOLITAIRE™ with the Intention for Thrombectomy (SWIFT) Trial: Design of a Randomized, Controlled, Multicenter Study Comparing the SOLITAIRE™ Flow Restoration Device and the MERCI Retriever in Acute Ischaemic Stroke
    J. L. Saver, R. Jahan, E. I. Levy, T. G. Jovin, B. Baxter, R. Nogueira, W. Clark, R. Budzik, O. O. Zaidat
    International Journal of Stroke 2014 9 5

More in this TOC Section

  • Effect of SARS-CoV2 on Endovascular Thrombectomy
  • A Key Factor Shapes LS-DAVFs EVT Outcome
  • MT in Mild LVO Stroke: ASSIST Registry Insights
Show more Neurointervention

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire