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Research ArticleNeurointervention
Open Access

Risks of Undersizing Stent Retriever Length Relative to Thrombus Length in Patients with Acute Ischemic Stroke

N.F. Belachew, T. Dobrocky, T.R. Meinel, A. Hakim, J. Vynckier, M. Arnold, D.J. Seiffge, R. Wiest, E.I. Piechowiak, U. Fischer, J. Gralla, P. Mordasini and J. Kaesmacher
American Journal of Neuroradiology October 2021, DOI: https://doi.org/10.3174/ajnr.A7313
N.F. Belachew
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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  • ORCID record for N.F. Belachew
T. Dobrocky
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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T.R. Meinel
bNeurology (T.R.M., J.V., M.A., D.J.S., U.F.)
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  • ORCID record for T.R. Meinel
A. Hakim
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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J. Vynckier
bNeurology (T.R.M., J.V., M.A., D.J.S., U.F.)
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M. Arnold
bNeurology (T.R.M., J.V., M.A., D.J.S., U.F.)
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D.J. Seiffge
bNeurology (T.R.M., J.V., M.A., D.J.S., U.F.)
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  • ORCID record for D.J. Seiffge
R. Wiest
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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E.I. Piechowiak
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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U. Fischer
bNeurology (T.R.M., J.V., M.A., D.J.S., U.F.)
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J. Gralla
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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P. Mordasini
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
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J. Kaesmacher
aFrom the Departments of Diagnostic and Interventional Neuroradiology (N.F.B., T.D., A.H., R.W., E.I.P., J.G., P.M., J.K.)
cDiagnostic, Interventional and Pediatric Radiology (J.K.), Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
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    FIG 1.

    A male patient with acute ischemic stroke after occlusion of the right MCA main trunk (M1-segment). The occlusive thrombus can be seen on SWI (A) as a circumscribed loss of signal along the main trunk of the MCA. Corresponding images of the arterial TOF sequence (B) and DSA (C) show the same vessel occlusion. Thrombus measurement was performed on multiplanar SWI reconstruction along the longitudinal axis of the occluded vessel (C). The red arrow points to the proximal end of the vessel occlusion on arterial TOF and DSA.

  • FIG 2.
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    FIG 2.

    A patient with acute ischemic stroke after occlusion of the basilar artery. The occlusive thrombus can be seen on SWI (A) as a circumscribed loss of signal along the basilar artery. Corresponding images of the arterial TOF sequence (B) and DSA (C) show the same vessel occlusion. The yellow crosshairs are centered on the middle portion of the vessel occlusion on arterial TOF (B). Thrombus measurement was performed on multiplanar SWI reconstruction along the longitudinal axis of the occluded vessel (C). The red arrow points to the proximal end of the vessel occlusion on digital subtraction angiography.

  • FIG 3.
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    FIG 3.

    First-pass eTICI distribution according to TL/SL quartiles (P = .004). The quartile limits are as follows: 0.25-quartile = 0.425; 0.5-quartile = 0.600; 0.75-quartile = 0.900. The black and red dotted lines mark the eTICI margins. The red dotted line also marks the threshold for successful recanalization defined as eTICI ≥ 2B.

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Cite this article
N.F. Belachew, T. Dobrocky, T.R. Meinel, A. Hakim, J. Vynckier, M. Arnold, D.J. Seiffge, R. Wiest, E.I. Piechowiak, U. Fischer, J. Gralla, P. Mordasini, J. Kaesmacher
Risks of Undersizing Stent Retriever Length Relative to Thrombus Length in Patients with Acute Ischemic Stroke
American Journal of Neuroradiology Oct 2021, DOI: 10.3174/ajnr.A7313

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Risks of Undersizing Stent Retriever Length Relative to Thrombus Length in Patients with Acute Ischemic Stroke
N.F. Belachew, T. Dobrocky, T.R. Meinel, A. Hakim, J. Vynckier, M. Arnold, D.J. Seiffge, R. Wiest, E.I. Piechowiak, U. Fischer, J. Gralla, P. Mordasini, J. Kaesmacher
American Journal of Neuroradiology Oct 2021, DOI: 10.3174/ajnr.A7313
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