{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T11:16:45Z","timestamp":1773487005363,"version":"3.50.1"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Mechanical thrombectomy has changed the landscape of acute ischemic stroke treatment, offering improved outcomes for patients with large vessel occlusions. The interplay between reperfusion techniques and occlusion sites remains a critical consideration in treatment decisions. This study investigates the impact of primary reperfusion techniques\u2014stent retriever classic, stent retriever combination with aspiration, and direct aspiration\u2014on procedural and clinical outcomes at different occlusion sites.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Using data from the ASSIST registry, a prospective multinational initiative, patients with anterior circulation acute ischemic stroke with large vessel occlusions (n = 1477) were included. Three primary occlusion sites\u2014M1 segment of the middle cerebral artery, M2 segment of the middle cerebral artery, and the internal carotid artery\u2014were studied. Univariate tests and multivariable logistic regression models were used to assess associations between reperfusion techniques and procedural and clinical outcomes, including the expanded thrombolysis in cerebral infarction score and the modified Rankin Scale, stratified by occlusion site.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Achieving expanded thrombolysis in cerebral infarction \u22652c after first pass was lower in internal carotid artery occlusions (18.2%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) with direct aspiration alone compared with stent retriever classic (38.2%) or stent retriever combination with aspiration (43.3%), while no differences were seen for M1 segment of the middle cerebral artery (\n              <jats:italic>P<\/jats:italic>\n              = 0.77) and M2 segment of the middle cerebral artery (\n              <jats:italic>P<\/jats:italic>\n              = 0.29) occlusions. Bailout maneuvers, which were more frequent in the direct aspiration group for all occlusion sites, did not result in longer procedure times or different final recanalization outcomes in direct aspiration compared with stent retriever classic or stent retriever combination with aspiration. Overall, there were no differences in the rate of patients with modified Rankin Scale scores of 0\u20132 at 90 days. No differences in safety outcomes were observed.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This study provides insight into the complex relationship between reperfusion techniques and occlusion sites in patients with acute ischemic stroke and shows that certain techniques have advantages in certain occlusion sites. As the field evolves, further research is warranted to refine our understanding of these dynamics and inform clinical practice.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.124.001446","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T10:46:23Z","timestamp":1729161983000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Impact of Reperfusion Techniques and Occlusion Sites in Thrombectomy: Insights from the ASSIST Stroke Registry"],"prefix":"10.1161","volume":"4","author":[{"given":"Ulf","family":"Neuberger","sequence":"first","affiliation":[{"name":"Heidelberg University Hospital","place":["Heidelberg"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori Lyn","family":"Price","sequence":"additional","affiliation":[{"name":"Stryker Neurovascular","place":["Fremont"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvador","family":"Miralb\u00e9s","sequence":"additional","affiliation":[{"name":"Hospital Son Espases","place":["Mallorca, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharath","family":"Naravetla","sequence":"additional","affiliation":[{"name":"McLaren Regional Medical Center","place":["Flint"]},{"name":"McLaren Regional Medical Center","place":["Macomb"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Spiotta","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina","place":["Charleston"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Loehr","sequence":"additional","affiliation":[{"name":"Klinikum Vest Recklinghausen","place":["Recklinghausen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Mart\u00ednez\u2010Gald\u00e1mez","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valladolid","place":["Valladolid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan A.","family":"McTaggart","sequence":"additional","affiliation":[{"name":"Rhode Island Hospital","place":["Providence"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Defreyne","sequence":"additional","affiliation":[{"name":"Ghent University Hospital","place":["Ghent, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Vega","sequence":"additional","affiliation":[{"name":"Hospital Universitario Central de Asturias\u2010HUCA","place":["Oviedo, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama O.","family":"Zaidat","sequence":"additional","affiliation":[{"name":"Neuroscience Department","place":["Toledo"]},{"name":"Bon Secours Mercy Health St. Vincent Medical Center","place":["Toledo"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"University of California","place":["Los Angeles"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi","family":"Gupta","sequence":"additional","affiliation":[{"name":"WellStar Health System","place":["Marietta"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-704X","authenticated-orcid":false,"given":"Markus Alfred","family":"M\u00f6hlenbruch","sequence":"additional","affiliation":[{"name":"Heidelberg University Hospital","place":["Heidelberg"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"the ASSIST","family":"Investigators","sequence":"additional","affiliation":[{"name":"Heidelberg University Hospital","place":["Heidelberg"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1136\/neurintsurg-2016-012581","article-title":"Stent retrieval thrombectomy in acute stoke is facilitated by the concurrent use of intracranial aspiration catheters","volume":"9","author":"Jindal G","year":"2017","unstructured":"Jindal G, Serulle Y, Miller T, Le E, Wozniak M, Phipps M, Iyoha M, Gupta V, Shivashankar R, Gandhi D. Stent retrieval thrombectomy in acute stoke is facilitated by the concurrent use of intracranial aspiration catheters. J Neurointerv Surg. 2017;9:944\u2013947. https:\/\/doi.org\/10.1136\/neurintsurg\u20102016\u2010012581","journal-title":"J Neurointerv Surg"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/1591019916632369","article-title":"ARTS (Aspiration\u2010Retriever Technique for Stroke): initial clinical experience","volume":"22","author":"Massari F","year":"2016","unstructured":"Massari F, Henninger N, Lozano JD, Patel A, Kuhn AL, Howk M, Perras M, Brooks C, Gounis MJ, Kan P, et\u00a0al. ARTS (Aspiration\u2010Retriever Technique for Stroke): initial clinical experience. 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Technique and impact on first pass effect primary results of the ASSIST global registry. J Neurointerv Surg. 2024:jnis\u20102023\u2010021126. https:\/\/doi.org\/10.1136\/jnis\u20102023\u2010021126","journal-title":"J Neurointerv Surg"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70264-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-017-1614-4"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2017-013179"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.124.001446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T11:40:07Z","timestamp":1741779607000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.124.001446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1161\/SVIN.124.001446"],"URL":"https:\/\/doi.org\/10.1161\/svin.124.001446","relation":{},"ISSN":["2694-5746"],"issn-type":[{"value":"2694-5746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e001446"}}