{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:19:01Z","timestamp":1789154341526,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">First\u2010pass reperfusion (FPR) is associated with favorable outcome after endovascular treatment. It is unknown whether this effect is independent of patient characteristics and whether FPR has better outcomes compared with excellent reperfusion (Expanded Thrombolysis in Cerebral Infarction [eTICI] 2C\u20103) after multiple\u2010passes reperfusion. We aimed to evaluate the association between FPR and outcome with adjustment for patient, imaging, and treatment characteristics to single out the contribution of FPR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">FPR was defined as eTICI 2C\u20103 after 1 pass. Multivariable regression models were used to investigate characteristics associated with FPR and to investigate the effect of FPR on outcomes. We included 2686 patients of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry. Factors associated with FPR were as follows: history of hyperlipidemia (adjusted odds ratio [OR], 1.05; 95% CI, 1.01\u20131.10), middle cerebral artery versus intracranial carotid artery occlusion (adjusted OR, 1.11; 95% CI, 1.06\u20131.16), and aspiration versus stent thrombectomy (adjusted OR, 1.07; 95% CI, 1.03\u20131.11). Interventionist experience increased the likelihood of FPR (adjusted OR, 1.03 per 50 patients previously treated; 95% CI, 1.01\u20131.06). Adjusted for patient, imaging, and treatment characteristics, FPR remained associated with a better 24\u2010hour National Institutes of Health Stroke Scale (NIHSS) score (\u221237%; 95% CI, \u221243% to \u221231%) and a better modified Rankin Scale (mRS) score at 3\u00a0months (adjusted common OR, 2.16; 95% CI, 1.83\u20132.54) compared with no FPR (multiple\u2010passes reperfusion+no excellent reperfusion), and compared with multiple\u2010passes reperfusion alone (24\u2010hour NIHSS score, (\u221223%; 95% CI, \u221231% to \u221214%), and mRS score (adjusted common OR, 1.45; 95% CI, 1.19\u20131.78)).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">FPR compared with multiple\u2010passes reperfusion is associated with favorable outcome, independently of patient, imaging, and treatment characteristics. Factors associated with FPR were the experience of the interventionist, history of hyperlipidemia, location of occluded artery, and use of an aspiration device compared with stent thrombectomy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019988","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T10:19:47Z","timestamp":1616149187000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Effect of First\u2010Pass Reperfusion on Outcome After Endovascular Treatment for Ischemic Stroke"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1650-951X","authenticated-orcid":false,"given":"Sanne J.","family":"den Hartog","sequence":"first","affiliation":[{"name":"Department of Neurology Erasmus MC, University Medical Center Rotterdam the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine Erasmus MC, University Medical Center Rotterdam the Netherlands"},{"name":"Department of Public Health Erasmus MC, University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4881-4698","authenticated-orcid":false,"given":"Osama","family":"Zaidat","sequence":"additional","affiliation":[{"name":"Department of Neurology Mercy St. Vincent Medical Center Toledo OH United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Roozenbeek","sequence":"additional","affiliation":[{"name":"Department of Neurology Erasmus MC, University Medical Center Rotterdam the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine Erasmus MC, University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-5051","authenticated-orcid":false,"given":"Adriaan C. 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