Contact Aspiration Combined with a Stent Retriever versus Contact Aspiration Alone in Mechanical Thrombectomy for Acute Ischemic Strokes: A Nationwide Analysis Using the Diagnosis Procedure Combination Database
Bibliographic record
Abstract
Objective: The technique combining a stent retriever (SR) and contact aspiration (CA) has been widely used in mechanical thrombectomy for acute ischemic stroke. However, advancements in large-bore aspiration catheters suggest that CA alone may achieve comparable therapeutic outcomes, while streamlining the procedure. Nevertheless, real-world evidence directly comparing these approaches is limited. Methods: We identified patients hospitalized for ischemic stroke who underwent mechanical thrombectomy between April 2020 and March 2023 from the Japanese national inpatient Diagnosis Procedure Combination database. Patients treated with CA or CA combined with SR (CA + SR) were enrolled. Propensity score overlap weighting was performed to adjust for confounders. The outcomes were intracranial hemorrhage (ICH), functional independence at discharge, in-hospital mortality, and total hospitalization cost. Results: Among 17589 eligible patients, 14892 underwent CA + SR and 2697 received CA. The adjusted proportions of ICH were comparable between the groups (1.4% vs. 1.3%; adjusted risk difference [aRD], 0.1%; 95% confidence interval [CI], -0.5% to 0.5%). The CA + SR group had a lower proportion of functional independence at discharge (28.7% vs. 36.2%; aRD, -7.5%; 95% CI, -9.5% to -5.4%) and higher in-hospital mortality (11.4% vs. 9.2%; aRD, 2.2%; 95% CI, 1.0%-3.5%). The total hospitalization costs (USD) were higher in the CA + SR group than in the CA group (21687 vs. 18317; difference, 3370; 95% CI, 2976-3764). Conclusions: The proportion of patients with ICH did not differ significantly between the CA + SR group and CA groups. CA + SR was associated with worse functional outcomes, higher in-hospital mortality, and higher costs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".