{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:47:09Z","timestamp":1794048429109,"version":"4.8.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Single-pass complete reperfusion using stent retrievers has been shown to improve functional outcome in patients with large vessel occlusion strokes. The aim of this study was to investigate the optimal size of stent retrievers to achieve one-pass complete reperfusion by mechanical thrombectomy.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The study evaluated the results of aspiration-assisted mechanical thrombectomy of acute isolated occlusion of the middle cerebral artery in the M1 segment with a novel 5 \u00d7 40-mm stent retriever compared to the usual 4 \u00d7 20-mm device. Reperfusion status was quantified using the Thrombolysis In Cerebral Infarction (TICI) scale. We hypothesized that thrombectomy of M1 occlusions with 5 \u00d7 40-mm stent retriever yields higher rates of complete first-pass reperfusion (FP) (TICI \u22652c after one pass) and successful or modified FP (mFP) (TICI \u22652b after one pass) than thrombectomy with 4 \u00d7 20. We included isolated M1 occlusions treated with pRESET 5 \u00d7 40 (phenox) as first-choice device for thrombectomy and compared with M1 occlusions treated with pRESET 4 \u00d7 20. We excluded patients with additional occlusions or tandem stenosis or who received an intracranial stent or angioplasty as a part of the endovascular treatment.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> One hundred thirteen patients were included in the 4 \u00d7 20 group and 57 patients in the 5 \u00d7 40 group. The 5 \u00d7 40 group achieved higher FP compared to 4 \u00d7 20 group [61.4% (35 of 57 patients) vs. 40.7% (46 of 113), respectively; adjusted odds ratio (OR) and 95% confidence interval (95% CI) = 2.20 (1.08\u20134.48), <jats:italic>p<\/jats:italic> = 0.030] and a higher mFP [68.4%, 39 of 57 patients vs. 48.7%, 55 of 113; adjusted OR (95% CI) = 2.11 (1.04\u20134.28), <jats:italic>p<\/jats:italic> = 0.037]. Frequency of successful reperfusion (TICI \u22652b) was similar in both groups (100 vs. 97.3%), but frequency of complete reperfusion (TICI \u22652c) was higher in the 5 \u00d7 40 group [82.5 vs. 61.9%, adjusted OR (95% CI) = 2.47 (1.01\u20136.04), <jats:italic>p<\/jats:italic> = 0.047]. Number of passes to achieve reperfusion was lower in the 5 \u00d7 40 group than in the 4 \u00d7 20 group [1.6 \u00b1 1.1 vs. 2 \u00b1 1.4, <jats:italic>p<\/jats:italic> = 0.033; adjusted incidence rate ratio (95% CI) = 0.84 (0.69\u20131.03), <jats:italic>p<\/jats:italic> = 0.096]. Modified Rankin scale at 90 days was similar in 5 \u00d7 40 and 4 \u00d7 20 groups.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> The size of stent retriever matters in acute M1 occlusions treated with aspiration-assisted mechanical thrombectomy. A longer stent retriever with a larger nominal diameter achieves a higher complete and successful FP and higher successful reperfusion compared to a shorter stent retriever.<\/jats:p>","DOI":"10.3389\/fneur.2021.679402","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T15:23:46Z","timestamp":1624980226000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":39,"title":["First-Pass Reperfusion by Mechanical Thrombectomy in Acute M1 Occlusion: The Size of Retriever Matters"],"prefix":"10.3389","volume":"12","author":[{"given":"Carmen","family":"Serna Candel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Aguilar 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