Evidence map›Paper›PMID 39578333›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025

Mechanical thrombectomy failure in anterior and posterior circulation stroke: current results from a high-volume comprehensive center.

Alexander Neumann, P Schildhauer, S M Weiler, P Schramm, H Schacht, G Royl, U Jensen-Kondering

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alexander NeumannDepartment of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany. alexander.neumann@uksh.de.ORCID http://orcid.org/0000-0002-5651-3900
P SchildhauerDepartment of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany.
S M WeilerExperimental Psychology Unit, Humanities and Social Sciences, Helmut Schmidt University / University of the Federal Armed Forces Hamburg, Holstenhofweg 85, Hamburg, 22043, Germany.
P SchrammDepartment of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany.
H SchachtDepartment of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany.
G RoylDepartment of Neurology, Neurovascular Center, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany.
U Jensen-KonderingDepartment of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMechanical thrombectomy (MT) is an established therapy for acute ischemic stroke (AIS), but recanalization is not always achieved. Common reasons are inadequate removal at the thrombus site and difficulties with the access route. In order to identify risk factors for MT failure we conducted a retrospective study on a high-volume comprehensive stroke center.

methodsEvaluation of 552 thrombectomies (2019-23; anterior and posterior circulation, direct aspiration +/- stent retriever [SR]). MT failures (= modified Thrombolysis in Cerebral Infarction score 0 or 1) were analyzed for age, sex, pre- and post-MT modified Rankin Scale, bridging intravenous thrombolysis (IVT), occlusion site (anterior / posterior circulation, proximal / distal), the Kaesmacher classification and time trend results.

resultsMT failure occurred in 56 patients (10.1%; median age 76; 53.6% female). Nineteen (33.9%) patients received IVT (p = 0.326). Logistic regression analysis did not show a significant association of age, sex or occlusion site with MT failure (p = 0.165, p = 0.738, p = 0.838). Distal MT generally demonstrated lower success rates (p < 0.01). According to the Kaesmacher classification SR failure was the most frequent cause of MT failure (category 2B: 48%, p < 0.001). Time trend analysis suggests improving recanalization rates in the further course (4 times in year-on-year comparison; p < 0.01).

conclusionMT failure occurs in AIS treatment, even in high-volume centers and occurs more frequently in distal occlusions. Improvements in device technology, particularly SR, and ongoing refinements in access route selection offer the prospect of better outcomes in the future.

Indexed as

Ischemic StrokeThrombectomyAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment FailureDirect aspirationDistal medium vessel occlusionLarge vessel occlusionMechanical thrombectomy failureStent retrieverStroke

Identifiers

PMID39578333
PMCPMC11772395

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.