{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:05:04Z","timestamp":1792807504052,"version":"4.5.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Stroke is a leading cause of morbidity and mortality in humans. Most strokes are ischemic in nature and early recanalization of occluded vessels determines good outcomes. Recanalization of occluded vessels depends on many angiographic and demographic features. These factors need to be identified for better patient overall outcomes. Better preoperative knowledge of factors can help in customizing our treatment approach and explaining the prognosis to the guardians of the patients. We aim to share our institutional experience with mechanical thrombectomy (MT) for stroke and studied factors that affect an angiographic recanalization of vessels. A retrospective single-center study was conducted involving 104 patients who underwent MT at our institution between January 2016 and December 2019. Patient demographics, baseline characteristics, pre- and postprocedural imaging findings, and other clinical data were meticulously reviewed. We divided patients into successful recanalization (modified thrombolysis in cerebral ischemia [mTICI] 2b or 3) and unsuccessful recanalization (mTICI 2a or 1) groups and various factors were analyzed to evaluate their impact on recanalization rates. In the univariate analysis, a significant association was observed between successful recanalization and several factors: the absence of rheumatic heart disease (RHD) as a risk factor (p\u2009=\u20090.035), the presence of a hyperdense vessel sign (p\u2009=\u20090.003), and the use of treatment methods including aspiration (p\u2009=\u20090.031), stent retriever (p\u2009=\u20090.001), and Solumbra (p\u2009=\u20090.019). However, in the multivariate analysis, none of these factors exhibited statistical significance. The presence of RHD is a risk factor associated with poor angiographic recanalization in all three MT treatment modalities. Based on the above variables we can guide the patients\/relatives prior to MT procedure for their better outcome and risk\u2013benefit ratio.<\/jats:p>","DOI":"10.1055\/s-0044-1787984","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T23:12:06Z","timestamp":1719357126000},"page":"462-471","source":"Crossref","is-referenced-by-count":2,"title":["Insights into Angiographic Recanalization of Large Arterial Occlusion: Institutional Experience with Mechanical Thrombectomy for Acute Ischemic Stroke"],"prefix":"10.1055","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8711-2023","authenticated-orcid":false,"given":"Bheru Dan","family":"Charan","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailesh B.","family":"Gaikwad","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savyasachi","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leve Joseph Devarajan","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. V. Padma","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awadh Kishore","family":"Pandit","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank Sharad","family":"Kale","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, 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the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association\/American Stroke Association","volume":"50","author":"W J Powers","year":"2019","journal-title":"Stroke"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1161\/01.STR.0000257304.21967.ba","article-title":"Site of arterial occlusion identified by transcranial Doppler predicts the response to intravenous thrombolysis for stroke","volume":"38","author":"M Saqqur","year":"2007","journal-title":"Stroke"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1706442","article-title":"Thrombectomy 6 to 24\u2009hours after stroke with a mismatch between deficit and infarct","volume":"378","author":"R G Nogueira","year":"2018","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular 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Aoki","year":"2019","journal-title":"J Neurol Sci"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"e000429","DOI":"10.1161\/SVIN.122.000429","article-title":"Outcomes of mechanical thrombectomy of acute basilar artery occlusion due to underlying intracranial atherosclerotic disease","volume":"3","author":"B Bartolini","year":"2023","journal-title":"Stroke Vasc Intervent Neurol"},{"issue":"03","key":"ref33","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1159\/000503001","article-title":"Factors associated with unsuccessful recanalization in mechanical thrombectomy for acute ischemic stroke","volume":"9","author":"T Goda","year":"2019","journal-title":"Cerebrovasc Dis Extra"},{"issue":"03","key":"ref34","doi-asserted-by":"crossref","first-page":"132","DOI":"10.5455\/ijsm.Acute-Recanalization-Thrombo-Embolic-Ischemic-Stroke-Aperio-device","article-title":"Acute recanalization of thrombo-embolic ischemic stroke with aperio device","volume":"4","author":"Y \u0130nan\u00e7","year":"2018","journal-title":"Int J Surg Med"}],"container-title":["Asian Journal of 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