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<meta name="DC.Title" content="Thrombus Attenuation Does Not Predict Angiographic Results of Mechanical Thrombectomy with Stent Retrievers" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3565" />
<meta name="DC.Date" content="2013-05-30" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers in acute stroke has emerged as a promising new technique, with the highest recanalization rate of the therapeutic procedures available thus far. However, in up to 20% of the cases, mechanical thrombectomy with stent retrievers results in poor angiographic outcomes, with Thrombolysis in Cerebral Infarction scores ≤2a. The purpose of this study was to investigate whether thrombus attenuation on the initial CT scan can predict the angiographic outcome of the recanalization procedure in MCA occlusions.

MATERIALS AND METHODS: The data of 70 patients with acute MCA occlusions who underwent endovascular treatment with stent retrievers in our department were included. We analyzed thrombus attenuations, angiographic outcome, and periprocedural thrombus fragmentation.

RESULTS: The mean thrombus attenuation was 49.8 ± 7.8 HU and the mean difference from the attenuation of the contralateral MCA was 9.9 ± 8.0 HU. There were no significant differences in the thrombus attenuations of occlusions that were successfully recanalized (modified Thrombolysis in Cerebral Infarction ≥2b) and those that were not. Neither were there significant correlations of thrombus attenuations and periprocedural thrombus fragmentations that occurred in 64.3%. We found a nonsignificantly higher rate of recanalizations with modified Thrombolysis in Cerebral Infarction ≥2b when the difference from the attenuation of the contralateral MCA was between 1–20 HU.

CONCLUSIONS: In contrast to results of other revascularization procedures as published in a recent study, the angiographic result of mechanical thrombectomy with stent retrievers is not predicted by thrombus attenuation.

### Abbreviations

mTICI
:   modified Thrombolysis in Cerebral Infarction
CAS
:   carotid artery stenting
ΔTM
:   difference between thrombus attenuation and attenuation of the contralateral MCA" />
<meta name="DC.Contributor" content="U. Yilmaz" />
<meta name="DC.Contributor" content="C. Roth" />
<meta name="DC.Contributor" content="W. Reith" />
<meta name="DC.Contributor" content="P. Papanagiotou" />
<meta name="article:published_time" content="2013-05-30" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Thrombus Attenuation Does Not Predict Angiographic Results of Mechanical Thrombectomy with Stent Retrievers" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Mechanical thrombectomy with stent retrievers in acute stroke has emerged as a promising new technique, with the highest recanalization rate of the therapeutic procedures available thus far. However, in up to 20% of the cases, mechanical thrombectomy with stent retrievers results in poor angiographic outcomes, with Thrombolysis in Cerebral Infarction scores ≤2a. The purpose of this study was to investigate whether thrombus attenuation on the initial CT scan can predict the angiographic outcome of the recanalization procedure in MCA occlusions.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The data of 70 patients with acute MCA occlusions who underwent endovascular treatment with stent retrievers in our department were included. We analyzed thrombus attenuations, angiographic outcome, and periprocedural thrombus fragmentation.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The mean thrombus attenuation was 49.8 ± 7.8 HU and the mean difference from the attenuation of the contralateral MCA was 9.9 ± 8.0 HU. There were no significant differences in the thrombus attenuations of occlusions that were successfully recanalized (modified Thrombolysis in Cerebral Infarction ≥2b) and those that were not. Neither were there significant correlations of thrombus attenuations and periprocedural thrombus fragmentations that occurred in 64.3%. We found a nonsignificantly higher rate of recanalizations with modified Thrombolysis in Cerebral Infarction ≥2b when the difference from the attenuation of the contralateral MCA was between 1–20 HU.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In contrast to results of other revascularization procedures as published in a recent study, the angiographic result of mechanical thrombectomy with stent retrievers is not predicted by thrombus attenuation.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2013/05/30" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A3565" />
<meta name="citation_pmid" content="23721900" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="INTERVENTIONAL" />
<meta name="citation_author" content="U. Yilmaz" />
<meta name="citation_author_institution" content="From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany." />
<meta name="citation_author" content="C. Roth" />
<meta name="citation_author_institution" content="From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany." />
<meta name="citation_author" content="W. Reith" />
<meta name="citation_author_institution" content="From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany." />
<meta name="citation_author" content="P. Papanagiotou" />
<meta name="citation_author_institution" content="From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany." />
<meta name="twitter:title" content="Thrombus Attenuation Does Not Predict Angiographic Results of Mechanical Thrombectomy with Stent Retrievers" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers in acute stroke has emerged as a promising new technique, with the highest recanalization rate of the therapeutic procedures available thus far. However, in up to 20% of the cases, mechanical thrombectomy with stent retrievers results in poor angiographic outcomes, with Thrombolysis in Cerebral Infarction scores ≤2a. The purpose of this study was to investigate whether thrombus attenuation on the initial CT scan can predict the angiographic outcome of the recanalization procedure in MCA occlusions.

MATERIALS AND METHODS: The data of 70 patients with acute MCA occlusions who underwent endovascular treatment with stent retrievers in our department were included. We analyzed thrombus attenuations, angiographic outcome, and periprocedural thrombus fragmentation.

RESULTS: The mean thrombus attenuation was 49.8 ± 7.8 HU and the mean difference from the attenuation of the contralateral MCA was 9.9 ± 8.0 HU. There were no significant differences in the thrombus attenuations of occlusions that were successfully recanalized (modified Thrombolysis in Cerebral Infarction ≥2b) and those that were not. Neither were there significant correlations of thrombus attenuations and periprocedural thrombus fragmentations that occurred in 64.3%. We found a nonsignificantly higher rate of recanalizations with modified Thrombolysis in Cerebral Infarction ≥2b when the difference from the attenuation of the contralateral MCA was between 1–20 HU.

CONCLUSIONS: In contrast to results of other revascularization procedures as published in a recent study, the angiographic result of mechanical thrombectomy with stent retrievers is not predicted by thrombus attenuation.

### Abbreviations

mTICI
:   modified Thrombolysis in Cerebral Infarction
CAS
:   carotid artery stenting
ΔTM
:   difference between thrombus attenuation and attenuation of the contralateral MCA" />
<meta name="og-title" property="og:title" content="Thrombus Attenuation Does Not Predict Angiographic Results of Mechanical Thrombectomy with Stent Retrievers" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2013/05/30/ajnr.A3565" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Mechanical thrombectomy with stent retrievers in acute stroke has emerged as a promising new technique, with the highest recanalization rate of the therapeutic procedures available thus far. However, in up to 20% of the cases, mechanical thrombectomy with stent retrievers results in poor angiographic outcomes, with Thrombolysis in Cerebral Infarction scores ≤2a. The purpose of this study was to investigate whether thrombus attenuation on the initial CT scan can predict the angiographic outcome of the recanalization procedure in MCA occlusions.

MATERIALS AND METHODS: The data of 70 patients with acute MCA occlusions who underwent endovascular treatment with stent retrievers in our department were included. We analyzed thrombus attenuations, angiographic outcome, and periprocedural thrombus fragmentation.

RESULTS: The mean thrombus attenuation was 49.8 ± 7.8 HU and the mean difference from the attenuation of the contralateral MCA was 9.9 ± 8.0 HU. There were no significant differences in the thrombus attenuations of occlusions that were successfully recanalized (modified Thrombolysis in Cerebral Infarction ≥2b) and those that were not. Neither were there significant correlations of thrombus attenuations and periprocedural thrombus fragmentations that occurred in 64.3%. We found a nonsignificantly higher rate of recanalizations with modified Thrombolysis in Cerebral Infarction ≥2b when the difference from the attenuation of the contralateral MCA was between 1–20 HU.

CONCLUSIONS: In contrast to results of other revascularization procedures as published in a recent study, the angiographic result of mechanical thrombectomy with stent retrievers is not predicted by thrombus attenuation.

### Abbreviations

mTICI
:   modified Thrombolysis in Cerebral Infarction
CAS
:   carotid artery stenting
ΔTM
:   difference between thrombus attenuation and attenuation of the contralateral MCA" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">U. Yilmaz</span>, <span class="highwire-citation-author" data-delta="1">C. Roth</span>, <span class="highwire-citation-author" data-delta="2">W. Reith</span> and <span class="highwire-citation-author" data-delta="3">P. Papanagiotou</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2013,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3565 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-50248--6978224749" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">U. Yilmaz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=U.%2BYilmaz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yilmaz%20U&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AU.%2BYilmaz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C. Roth </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BRoth%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Roth%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.%2BRoth%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">W. Reith </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.%2BReith%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Reith%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AW.%2BReith%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">P. Papanagiotou </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology, Saarland University Hospital, Homburg, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BPapanagiotou%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Papanagiotou%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BPapanagiotou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Mechanical thrombectomy with stent retrievers in acute stroke has emerged as a promising new technique, with the highest recanalization rate of the therapeutic procedures available thus far. However, in up to 20% of the cases, mechanical thrombectomy with stent retrievers results in poor angiographic outcomes, with Thrombolysis in Cerebral Infarction scores ≤2a. The purpose of this study was to investigate whether thrombus attenuation on the initial CT scan can predict the angiographic outcome of the recanalization procedure in MCA occlusions.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> The data of 70 patients with acute MCA occlusions who underwent endovascular treatment with stent retrievers in our department were included. We analyzed thrombus attenuations, angiographic outcome, and periprocedural thrombus fragmentation.</p>
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<p id="p-3"><strong>RESULTS:</strong> The mean thrombus attenuation was 49.8 ± 7.8 HU and the mean difference from the attenuation of the contralateral MCA was 9.9 ± 8.0 HU. There were no significant differences in the thrombus attenuations of occlusions that were successfully recanalized (modified Thrombolysis in Cerebral Infarction ≥2b) and those that were not. Neither were there significant correlations of thrombus attenuations and periprocedural thrombus fragmentations that occurred in 64.3%. We found a nonsignificantly higher rate of recanalizations with modified Thrombolysis in Cerebral Infarction ≥2b when the difference from the attenuation of the contralateral MCA was between 1–20 HU.</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> In contrast to results of other revascularization procedures as published in a recent study, the angiographic result of mechanical thrombectomy with stent retrievers is not predicted by thrombus attenuation.</p>
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</div><div class="section glossary" id="glossary-1">
<h3>Abbreviations</h3>
<dl id="def-list-1"><dt id="def-item-1">mTICI<span class="def-item-dt-sep"></span></dt><dd>modified Thrombolysis in Cerebral Infarction<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">CAS<span class="def-item-dt-sep"></span></dt><dd>carotid artery stenting<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">ΔTM<span class="def-item-dt-sep"></span></dt><dd>difference between thrombus attenuation and attenuation of the contralateral MCA</dd></dl>
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2013, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3565 </span></div>
  
  
  
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