Stroke and Vascular Neurology ()
Mechanical thrombectomy with combined stent retriever and contact aspiration versus stent retriever alone for acute large vessel occlusion: data from ANGEL-ACT registry
- ,
- Ning Ma,
- Xiangqun Shi,
- Lianbo Gao,
- Yajie Liu,
- Yongli Li,
- Dapeng Mo,
- Feng Gao,
- Zhongrong Miao,
- Yan Liu,
- Zengwu Wang,
- Yan Wang,
- Wei Wang,
- Weihua Wu,
- Liping Wei,
- Ping Xu,
- Jianfeng Zhou,
- Hao Li,
- Lei Yang,
- Yang Hua,
- Xiaochuan Huo,
- Ya Peng,
- Wenhuo Chen,
- Shengli Chen,
- Cunfeng Song,
- Ping Jing,
- Junfeng Zhao,
- Liqiang Gui,
- Zhiming Zhou,
- Anxin Wang,
- Zhimin Wang,
- Yibin Cao,
- Hongwei Wang,
- Dong Wang,
- Peng Zhang,
- Zhonghua Shi,
- Haitao Guan,
- Chao Wang,
- Long Chen,
- Xue Wen,
- Wei Dong,
- Hui Liang,
- Chunlei Li,
- Qingfeng Zhu,
- Jun Wei,
- Yun Xu,
- Xiang Luo,
- Jin Wu,
- Zhi Yang,
- Yongqiang Zhang,
- Baixue Jia,
- Yaxuan Sun,
- Guilian Zhang,
- Gang Xie,
- Chong Li,
- Yuwu Zhao,
- Wang Bo,
- Shugui Shi,
- Yan Xiao,
- Xiaoxiang Peng,
- Zaiyu Guo,
- Ning Guan,
- Haihua Yang,
- Gaoting Ma,
- Xu Tong,
- Guangxiong Yuan,
- Deqin Geng,
- Dapeng Sun,
- Raynald,
- Leyuan Wang,
- Yijiu Lu,
- Xianjun Wang,
- Zhenzhong Zhang,
- Shijun Zhao,
- Qingshi Zhao,
- Qingchun Gao,
- Weirong Li,
- Xiaojiang Cheng,
- Xinyu Lu,
- Dengxiang Wang,
- Haicheng Yuan,
- Xuancong Liufu,
- Wenwu Yang,
- Wenji Jing,
- WenWu Peng,
- Lixin Wang,
- Wanming Wang,
- Pu Yuan,
- Wenbao Liang,
- Daliang Ma,
- Xiangdong Xie,
- Xiangjun Zeng,
- Fanfan Su,
- MingZe Chang,
- Jijun Yin,
- Hongxia Sun,
- Yong Bi,
- Dongqun Li,
- Zhonglun Chen,
- Lin Yin,
- HongKai Qiu,
- Xiaoya Feng,
- Tan Lan,
- Qilong Liang Li Ding,
- Jianwen Yang,
- Quanle Zheng,
- Zhenyun Zhu,
- Liyue Zhao,
- Qingbo Meng,
- Yuqing Wei,
- Dong Sun,
- Yongxing Yan,
- Yadong Yang,
- Huihong Wang,
- Xianglin Chen,
- Juntao Li,
- Xiang Yong,
- Mingkai Hu,
- Yu Xin Wang
Affiliations
- 1The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
- Ning Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- Xiangqun Shi
- Lianbo Gao
- Yajie Liu
- 1 State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- Yongli Li
- Dapeng Mo
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People`s Republic of China
- Feng Gao
- Department of Intervention, Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Zhongrong Miao
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People`s Republic of China
- Yan Liu
- 1State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Zengwu Wang
- Yan Wang
- Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, China
- Wei Wang
- 2Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, China
- Weihua Wu
- Liping Wei
- Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
- Ping Xu
- Department of Pharmacy, Ningbo City First Hospital, Ningbo, Zhejiang, China
- Jianfeng Zhou
- Hao Li
- 1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Lei Yang
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Yang Hua
- Xiaochuan Huo
- 1 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Ya Peng
- Department of Neurosurgery, Changzhou No. 1 People`s Hospital, Changzhou, China
- Wenhuo Chen
- Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
- Shengli Chen
- Cunfeng Song
- Ping Jing
- Junfeng Zhao
- Neurology, Siping Central People’s Hospital, Siping, China
- Liqiang Gui
- Zhiming Zhou
- Department of Intervention, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
- Anxin Wang
- 4 China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China
- Zhimin Wang
- Yibin Cao
- Hongwei Wang
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Dong Wang
- Peng Zhang
- 1 Beijing Children`s Hospital, Capital Medical University, Beijing, China
- Zhonghua Shi
- Haitao Guan
- Chao Wang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Long Chen
- Xue Wen
- Wei Dong
- 2 Department of Orthopaedics, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
- Hui Liang
- Chunlei Li
- Qingfeng Zhu
- Jun Wei
- Yun Xu
- Xiang Luo
- 1 Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
- Jin Wu
- Neurology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Zhi Yang
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yongqiang Zhang
- Baixue Jia
- 1 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yaxuan Sun
- Guilian Zhang
- Neurology, The Second Affiliated Hospital of Xi`an Jiaotong University, Xi`an, China
- Gang Xie
- Chong Li
- Department of Osteoporosis, The First People`s Hospital of Kunshan Affiliated with Jiangsu University, Kunshan, Jiangsu, People`s Republic of China
- Yuwu Zhao
- 2 Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Wang Bo
- Shugui Shi
- Yan Xiao
- Xiaoxiang Peng
- Zaiyu Guo
- Ning Guan
- Haihua Yang
- Gaoting Ma
- 1 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xu Tong
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People`s Republic of China
- Guangxiong Yuan
- Deqin Geng
- 9 Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Dapeng Sun
- 1 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Raynald
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People`s Republic of China
- Leyuan Wang
- Yijiu Lu
- Xianjun Wang
- Zhenzhong Zhang
- Shijun Zhao
- Qingshi Zhao
- Qingchun Gao
- Weirong Li
- Xiaojiang Cheng
- Xinyu Lu
- Dengxiang Wang
- Haicheng Yuan
- Neurology, Qingdao Central Medical Group, Qingdao, China
- Xuancong Liufu
- Wenwu Yang
- Wenji Jing
- WenWu Peng
- Lixin Wang
- Wanming Wang
- Pu Yuan
- Wenbao Liang
- Daliang Ma
- Xiangdong Xie
- Xiangjun Zeng
- Fanfan Su
- MingZe Chang
- Jijun Yin
- Hongxia Sun
- Yong Bi
- Dongqun Li
- Zhonglun Chen
- Lin Yin
- HongKai Qiu
- Xiaoya Feng
- Tan Lan
- Qilong Liang Li Ding
- Jianwen Yang
- Quanle Zheng
- Zhenyun Zhu
- Liyue Zhao
- Qingbo Meng
- Yuqing Wei
- Dong Sun
- Yongxing Yan
- Yadong Yang
- Huihong Wang
- Xianglin Chen
- Juntao Li
- Xiang Yong
- Mingkai Hu
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yu Xin Wang
Abstract
Background and purpose An analysis of the ASTER 2 trial revealed similar final recanalisation levels and clinical outcomes in acute large vessel occlusion (LVO) stroke between stent retrieval (SR) alone as a first-line mechanical thrombectomy (MT) technique (SR alone first-line) and concomitant use of contact aspiration (CA) plus SR as a first-line MT technique (SR+CA first-line). The purpose of the present study was to compare the safety and efficacy of SR+CA first-line with those of SR alone first-line for patients with LVO in China.Methods We conducted the present study by using the data from the ANGEL-ACT registry. We divided the selected patients into SR+CA first-line and SR alone first-line groups. We performed logistic regression and generalised linear models with adjustments to compare the angiographic and clinical outcomes, including successful/complete recanalisation after the first technique alone and all procedures, first-pass successful/complete recanalisation, number of passes, 90-day modified Rankin Scale, procedure duration, rescue treatment and intracranial haemorrhage within 24 hours.Results Of the 1233 enrolled patients, 1069 (86.7%) received SR alone first-line, and 164 (13.3%) received SR+CA first-line. SR+CA first-line was associated with more thrombectomy passes (3 (2–4) vs 2 (1–2); β=1.77, 95% CI=1.55 to 1.99, p<0.001), and longer procedure duration (86 (60–129) min vs 80 (50–122) min; β=10.76, 95% CI=1.08 to 20.43, p=0.029) than SR alone first-line group. Other outcomes were comparable (all p>0.05) between the two groups.Conclusions Patients undergoing SR+CA first-line had more thrombectomy passes and longer procedure duration than patients undergoing SR alone first-line. Additionally, we suggested that SR+CA first-line was not superior to SR alone first-line in final recanalisation level, first-pass recanalisation level and 90-day clinical outcomes in the Chinese population.
