P-024 Balloon guide catheter use for stroke intervention: does the access site matter?
Notice bibliographique
Résumé
Introduction Previous studies suggested that patients treated with MT via transradial approach (TRA) had inferior angiographic and clinical outcomes due to non-use of balloon guide catheters (BGCs). Therefore, we described the sheathless TRA (sTRA) technique, which allows the use of BGC through the radial artery. In this study, we evaluate MT via TFA and sTRA, aiming to compare the angiographic and clinical outcomes of patients treated with each approach. Methods Retrospective MT database analysis from December 2020 and January 2021. Inclusion criteria were 1) ≥18-year-old; 2) internal carotid artery, M1, M2 occlusion; 3) Alberta Stroke Program Early Computed Tomography Score ≥6; 4) Pre-stroke modified Rankin Scale (mRS) ≤2; 5) use of an inflated Walrus balloon-guide catheter (BGC) during clot retrieval through either TFA or sTRA. Demographics, procedural information, and clinical outcomes at 90-days were extracted. First pass effect (FPE) and modified FPE (mFPE) were defined as mTICI≥2b and mTICI≥2c, respectively, within single-pass without need for rescue-therapy. Functional independence and poor outcome were defined as mRS≤2 and mRS>2 at 90-days, respectively. Results Ninety-three patients (TRA, 34 vs TFA 59) were included. The groups were similar regarding age, sex, hypertension, hyperlipidemia, diabetes, and atrial fibrillation, NIHSS at admission, administration of intravenous alteplase, and occlusion location (table 1). Times from last known well to puncture and from puncture to recanalization were not significantly different between the groups (table 1). Crossover rate was significantly higher in the TRA (11.8%) than in the TFA (0%) group (P=0.016). There were no differences between the groups regarding stent-retriever alone, aspiration alone or combined technique as first approach (table 1). The rates of FPE and mFPE were not significantly different between the groups. There were no differences in the rates of PH2, median length of hospital stays, or in-hospital mortality between TRA and TFA. At 90-days, the rates of functional independence and mortality were not significantly different between the groups. Univariable logistic regression identified age, NIHSS at admission, and length of hospital stay as predictors of poor outcome, while mFPE had significantly lower odds of poor outcome (table 2). Multivariable regression including these variables identified NIHSS at admission as predictor of poor outcome and mFPE as reduced odds of poor outcome (table 2). Conclusions Patients treated with MT via TFA or sTRA had similar angiographic and clinical outcomes, differing only in the rate of crossover from one approach to another. Disclosures M. Waqas: None. A. Monteiro: None. J. Cappuzzo: None. R. Dossani: None. F. Almayman: None. W. Metcalf-Doetsch: None. K. Snyder: 2; C; Boston Scientific, Canon Medical Systems USA, Inc., MicroVention, Medtronic, Stryker Neurovascular.. 3; C; Canon Medical Systems USA. 4; C; Boston Scientific, Access Closure Inc, Niagara Gorge Medical. J. Davies: 1; C; NIH NINDS, NSF SBIR. 2; C; Medtronic. 4; C; Synchron, Cerebrotech, QAS.ai, RIST. A. Siddiqui: 2; C; Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., Cerenovus, Cerevatech Medical, Inc.,. 4; C; Adona Medical, Inc., Amnis Therapeutics, Bend IT Technologies, Ltd., BlinkTBI, Inc, Buffalo Technology Partners, Inc., Cardinal Consultants, LLC, Cerebrotech Medical Systems, Inc, Cerevatech Medical,. E. Levy: 2; C; Claret Medical, GLG Consulting, Guidepoint Global, Imperial Care, Medtronic, Rebound, StimMed, Misionix, Mosiac, Clarion, IRRAS. 3; C; Medtronic. 4; C; NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, Three Rivers Medical.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».