{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:12:01Z","timestamp":1774620721318,"version":"3.50.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The relationship between pass number during endovascular stroke therapy (EST) and outcomes in anterior circulation large vessel occlusion (LVO) acute ischemic stroke (AIS) has been well studied. However, the association between EST attempts and outcomes for patients with posterior circulation LVO remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">From our prospectively maintained multicenter registry, we identified consecutive patients with LVO AIS who underwent EST. The number of thrombectomy passes and per\u2010pass reperfusion grades (thrombolysis in cerebral infarction) were recorded prospectively at the time of procedure. The primary outcome was the association of number of EST passes and functional independence (modified Rankin scale 0\u20132) at 90\u00a0days. Secondary outcomes included likelihood of attaining substantial reperfusion (thrombolysis in cerebral infarction 2b\u20103).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 894 patients with LVO AIS who underwent EST, median age was 68 [interquartile range 58\u201378], 49% were female, and median National Institutes of Health Stroke Scale was 16 [interquartile range 11\u201321]. Of this cohort, 86 (9.6%) had posterior circulation LVO, including 65 (7%) with basilar artery occlusion and 9 (1%) with vertebral artery occlusion. The diminishing benefit on successful reperfusion of additional passes was similar for anterior and posterior circulation AIS. Among patients with posterior circulation stroke, successful reperfusion with fewer passes was associated with greater likelihood of good functional outcome at 90\u00a0days (40.0% versus 4.8% modified Rankin scale 0\u20132 with 1\u20132 versus 3+ passes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). The likelihood of good outcome in patients with posterior circulation LVO treated with EST and successful reperfusion in 1\u20132 passes was comparable to patients with anterior circulation LVO (40.0% versus 40.2%, posterior versus anterior;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.553).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The number of EST passes has a significant association with functional independence at 90\u00a0days for patients with posterior circulation LVO AIS. After 2 passes, there is significantly reduced benefit conferred by additional passes. Overall clinical outcomes in patients with successful reperfusion with 1\u20132 passes were similar in patients with posterior circulation compared with anterior circulation LVO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/svin.122.000663","type":"journal-article","created":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T06:58:55Z","timestamp":1677308335000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Endovascular Stroke Therapy for Posterior Circulation Acute Ischemic Stroke Has Diminishing Benefit with Additional Passes"],"prefix":"10.1161","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6285-9350","authenticated-orcid":false,"given":"Jerome A.","family":"Jeevarajan","sequence":"first","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun\u2010Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Bilal","family":"Tariq","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio Salazar","family":"Marioni","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arash","family":"Niktabe","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rania","family":"Abdelkhaleq","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"McCullough","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil A.","family":"Sheth","sequence":"additional","affiliation":[{"name":"The University of Texas Health Houston","place":["Houston"]},{"name":"Memorial Hermann Health System","place":["Houston"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012515"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.018925"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706442"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30395-3"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030297"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207576"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206317"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.020315"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028891"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1958"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021320"},{"key":"e_1_3_2_15_2","first-page":"e444","article-title":"Impact of repeated clot retrieval attempts on infarct growth and outcome after ischemic stroke","volume":"97","author":"Hassen B","year":"2021","unstructured":"Hassen B, Touloupas C, Benzakoun J, Boulouis G, Bretzner M, Bricout N, Legrand L, Rodriguez C, Le Berre A, Seners P, et\u00a0al. Impact of repeated clot retrieval attempts on infarct growth and outcome after ischemic stroke. Neurology, 2021;97:e444\u2010e453.","journal-title":"Neurology"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029830"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-017507"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2020-016952"},{"key":"e_1_3_2_19_2","article-title":"First pass effect in posterior circulation occlusions: analysis from the CICAT registry","author":"Terce\u00f1o M","year":"2022","unstructured":"Terce\u00f1o M, Silva Y, Bashir S, Chamorro \u00c1, P\u00e9rez de la Ossa N, Hernandez\u2010P\u00e9rez M, Casta\u00f1o C, Camps\u2010Renom P, Wenger D, Cardona P, et\u00a0al. First pass effect in posterior circulation occlusions: analysis from the CICAT registry. Int J Stroke. 2022:17474930221089772.","journal-title":"Int J Stroke"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.09.171"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1159\/000503001"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5759"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-014-3200-3"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011525"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014380"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493017743051"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.122.000663","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:07:09Z","timestamp":1774616829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.122.000663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1161\/SVIN.122.000663"],"URL":"https:\/\/doi.org\/10.1161\/svin.122.000663","relation":{},"ISSN":["2694-5746"],"issn-type":[{"value":"2694-5746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2022-09-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-08","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000663"}}