Table 2.
Outcome measures of patients undergoing thrombectomy with DA first-line versus SR first-line.
| Outcome variable | DA first-line | SR first-line | Unadjusted model |
Adjusted model 1a |
Adjusted model 2b |
|||
|---|---|---|---|---|---|---|---|---|
| Effect size (95% CI) | p-Value | Effect size (95% CI) | p-Value | Effect size (95% CI) | p-Value | |||
| Primary outcome | ||||||||
| Successful recanalization after first-device alonef | 31/102 (30.4) | 746/1123 (66.4) | 0.22 (0.14–0.34)c | <0.01 | 0.23 (0.15–0.37)c | <0.01 | 0.24 (0.15–0.37)c | <0.01 |
| Secondary outcomes | ||||||||
| Complete recanalization after first-device aloneg | 25/102 (24.5) | 582/1123 (51.8) | 0.30 (0.19–0.48)c | <0.01 | 0.33 (0.20–0.53)c | <0.01 | 0.31 (0.19–0.51)c | <0.01 |
| Successful recanalization after first-passf | 29/102 (28.4) | 404/1123 (36.0) | 0.71 (0.45–1.11)c | 0.13 | 0.82 (0.52–1.29)c | 0.39 | 0.83 (0.52–1.31)c | 0.42 |
| Complete recanalization after first-passg | 24/102 (23.5) | 325/1123 (28.9) | 0.76 (0.47–1.22)c | 0.25 | 0.84 (0.51–1.37)c | 0.48 | 0.83 (0.51–1.37)c | 0.47 |
| Number of passes, median (IQR) | 2 (1–4) | 1 (1–2) | 0.94 (0.68–1.20)d | <0.01 | 0.79 (0.53–1.05)d | <0.01 | 0.74 (0.48–1.01)d | <0.01 |
| Use of rescue treatment | 64/102 (62.8) | 303/1123 (27.0) | 4.56 (3.00–6.95)c | <0.01 | 4.55 (2.92–7.08)c | <0.01 | 4.51 (2.90–7.02)c | <0.01 |
| Switching to other thrombectomy devices | 58/102 (56.9) | 45/1123 (4.0) | 31.58 (19.30–51.67)c | <0.01 | 27.67 (16.28–47.01)c | <0.01 | 25.41 (15.18–42.53)c | <0.01 |
| Intra-arterial thrombolysis | 2/102 (2.0) | 20/1123 (1.8) | 1.10 (0.25–4.79)c | 0.90 | 0.95 (0.21–4.37)c | 0.95 | 1.15 (0.25–5.30)c | 0.86 |
| Balloon angioplasty | 12/102 (11.8) | 167/1123 (14.9) | 0.76 (0.41–1.43)c | 0.40 | 0.81 (0.42–1.55)c | 0.53 | 0.88 (0.46–1.68)c | 0.70 |
| Stenting | 11/102 (10.8) | 158/1123 (14.1) | 0.74 (0.39–1.41)c | 0.36 | 0.79 (0.40–1.54)c | 0.48 | 0.81 (0.41–1.58)c | 0.54 |
| Successful recanalization after all proceduresf | 86/102 (84.3) | 1014/1123 (90.3) | 0.58 (0.33–1.02)c | 0.06 | 0.67 (0.37–1.21)c | 0.18 | 0.74 (0.40–1.35)c | 0.33 |
| Complete recanalization after all proceduresg | 70/102 (68.6) | 777/1123 (69.2) | 0.97 (0.63–1.51)c | 0.91 | 1.07 (0.68–1.68)c | 0.77 | 1.02 (0.65–1.61)c | 0.92 |
| Procedure duration, median (IQR), min | 84 (50–150) | 80 (50–123) | 6.81 (−5.30 to 18.91)d | 0.27 | 4.39 (−8.02 to 16.81)d | 0.49 | 4.30 (−8.32 to 16.91)d | 0.50 |
| mRS at 90 d, median (IQR) | 3 (0–5) | 3 (0–5) | 0.94 (0.65–1.36)e | 0.73 | 1.03 (0.70–1.50)e | 0.90 | 0.99 (0.67–1.44)e | 0.94 |
| mRS 0–1 at 90 d | 37/95 (39.0) | 423/1072 (39.5) | 0.98 (0.64–1.51)c | 0.92 | 1.11 (0.71–1.73)c | 0.65 | 1.02 (0.66–1.59)c | 0.93 |
| mRS 0–2 at 90 d | 40/95 (42.1) | 467/1072 (43.6) | 0.94 (0.62–1.44)c | 0.78 | 1.03 (0.67–1.60)c | 0.88 | 0.96 (0.62–1.49)c | 0.86 |
| mRS 0–3 at 90 d | 46/95 (48.4) | 583/1072 (54.4) | 0.79 (0.52–1.20)c | 0.26 | 0.85 (0.55–1.31)c | 0.45 | 0.81 (0.53–1.25)c | 0.34 |
| Safety outcomes | ||||||||
| Intra-procedural embolization | 6/102 (5.9) | 61/1123 (5.4) | 1.09 (0.46–2.58)c | 0.85 | 0.79 (0.32–1.94)c | 0.61 | 0.68 (0.27–1.73)c | 0.42 |
| Any ICH within 24 h | 34/96 (35.4) | 237/1074 (22.1) | 1.94 (1.24–3.01)c | <0.01 | 1.78 (1.12–2.83)c | 0.02 | 1.69 (1.06–2.69)c | 0.03 |
| Symptomatic ICH within 24 hh | 13/96 (13.54) | 76/1068 (7.1) | 2.05 (1.09–3.84)c | 0.03 | 1.65 (0.84–3.26)c | 0.15 | 1.51 (0.77–2.96)c | 0.23 |
| Death within 90 d | 15/95 (15.8) | 181/1072 (16.9) | 0.92 (0.52–1.64)c | 0.78 | 0.82 (0.45–1.51)c | 0.53 | 0.82 (0.45–1.48)c | 0.51 |
Data are shown as the event number/total number (%), unless otherwise indicated.
Adjusted for the baseline variables with a significant difference of p < 0.05 between both groups, including occlusion site, tandem lesions, TOAST subtype, intravenous thrombolysis.
Adjusted for the propensity score.
The OR values were calculated using a binary logistic regression model.
The β-coefficients were calculated using a generalized linear model.
The common OR values were calculated using an ordinal logistic regression model and indicated the odds of improvement of 1 point on the mRS at 90 days.
Defined as mTICI of 2b-3.
Defined as mTICI of 3.
According to the Heidelberg Bleeding Classification.
CI, confidence interval; DA, direct aspiration; ICH, intracranial hemorrhage; IQR, interquartile range; mRS, modified Rankin Scale; mTICI, modified Thrombolysis in Cerebral Infarction; OR, odds ratio; SR, stent retriever; TOAST, Trial of ORG 10172 in Acute Stroke Treatment.