title: Impact of temporary opening using a stent retriever on clinical outcome in acute ischemic stroke.
abstract: BACKGROUND
  Stent retriever has a distinct ability to restore blood flow temporarily before achieving final reperfusion. There has been a limited report regarding the clinical impact of it. We investigated if temporary opening of occluded vessels using a stent retriever before final reperfusion might improve clinical outcome in acute ischemic stroke patients who received the endovascular reperfusion treatment.
  
  
  METHODS
  We enrolled consecutive ischemic stroke patients who had an initial occlusive lesion in the anterior circulation and achieved final reperfusion (Thrombolysis In Cerebral Infarction [TICI] ≥2) by endovascular treatment. Temporary opening was defined as the presence of ante grade flow (TICI≥2) during deployment of a stent retriever. Favorable outcome was defined as a modified Rankin scale score≤2 at 90 day.
  
  
  RESULTS
  A total of 98 patients were included in the study and temporary opening was achieved in 49 (50%). Temporary opening was associated with favorable outcome (odds ratio, 7.825; 95% confidence interval, 1.592-38.461; p = 0.011) in the multivariate analysis. The probability of having a favorable outcome tended to decrease as time from onset to final reperfusion increased in patients without temporary opening. However, this trend was not evident in the patient with temporary opening. The beneficial effect of temporary opening on clinical outcome seemed to be present in patients with good collaterals but not in patients with poor collaterals.
  
  
  CONCLUSIONS
  Temporary opening of occluded vessel using a stent retriever may be beneficial for improving clinical outcome in acute ischemic stroke patients.
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors: Dongbeom
authors: D
authors: Song
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors: Ji Hoe
authors: JH
authors: Heo
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Dong Ik
authors: DI
authors: Kim
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Dong Joon
authors: DJ
authors: Kim
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Byung Moon
authors: BM
authors: Kim
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors: Kijeong
authors: K
authors: Lee
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors: Joonsang
authors: J
authors: Yoo
authors: Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.
authors: Hye Sun
authors: HS
authors: Lee
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors: Hyo Suk
authors: HS
authors: Nam
authors: Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
authors: Young Dae
authors: YD
authors: Kim
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000628:therapy*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D015424:Reperfusion; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000628:therapy*; D017131:Thrombectomy; D016896:Treatment Outcome