Melanie R. F. Greenway, MD
Flottmann F, Brekenfeld C, Broocks G, Leischner H, McDonough R, Faizy T, Deb-Chatterji M, Alegiani A, Thomalla G, Mpotsaris A, et al. Good Clinical Outcome Decreases With Number of Retrieval Attempts in Stroke Thrombectomy: Beyond the First-Pass Effect. Stroke. 2021;52:482-490.
Between discussion of the “First Pass Effect”1,2 and wondering “When to Stop,”3 finding a magic number of retrieval attempts that optimizes potential good outcome and minimizes risk of adverse events continues to be an important clinical question.
Utilizing the German Stroke Registry-Endovascular Treatment section, the authors focused on reviewing number of retrieval attempts as it correlates with final TICI score and modified Rankin Score (mRS) at 90 days. They analyzed 2611 patients from 2015-2018, 1225 of which met inclusion and exclusion criteria. All patients included were 18 years of age or older, underwent endovascular therapy of the intracranial anterior circulation, and had a complete set of data needed for the study. A successful reperfusion was defined as TICI 2b or 3, and a “good clinical outcome” was defined as mRS 0-2.