Table 2.
Effect estimates for the association between interventionist’s experience number (EXPno) per 10 procedures and clinical, radiological, and workflow outcomes
| EXPno <45 (n=1285) |
EXPno ≥45 (n=1304) |
EE | Unadjusted (95% CI) |
Adjusted (95% CI) |
|
| Clinical outcomes | |||||
| NIHSS score at 24–48 hours, median (IQR) | 11 (4.0–18), 1187 | 10 (4.0–17), 1221 | β | −0.14 (−0.25 to −0.03) | −0.09 (−0.20 to 0.01) |
| mRS score at 90 days, median (IQR) | 3 (2-6), 1200 | 3 (2-6), 1219 | cOR | 0.99 (0.97 to 1.01) | 0.99 (0.97 to 1.02) |
| Mortality at 90 days, n (%) | 332/1200 (28) | 357/1219 (29) | OR | 1.00 (0.98 to 1.03) | 1.00 (0.98 to 1.03) |
| Safety outcomes, n (%) | |||||
| Occurrence any SAEs* | 541/1285 (42) | 496/1304 (38) | OR | 0.974 (0.953 to 0.996) | 0.97 (0.95 to 1.00) |
| Stroke progression† | 124/1285 (9.6) | 122/1304 (9.4) | OR | 0.99 (0.95 to 1.02) | 0.98 (0.94 to 1.02) |
| New ischemic stroke† | 16/1285 (1.2) | 25/1304 (1.9) | OR | 1.08 (1.00 to 1.17) | 1.06 (0.98 to 1.15) |
| Symptomatic ICH* | 80/1285 (6.2) | 83/1304 (6.4) | OR | 0.98 (0.94 to 1.03) | 0.97 (0.93 to 1.02) |
| Imaging outcomes | |||||
| Postinterventional eTICI score, median (IQR)† | 2B (2A–3), 1262 | 2C (2A–3), 1265 | cOR | 1.06 (1.04 to 1.08) | 1.05 (1.02 to 1.08) |
| Recanalization, n (%)† | 741/1262 (59) | 900/1263 (71) | OR | 1.07 (1.05 to 1.10) | 1.08 (1.04 to 1.12) |
| Safety outcomes scored on DSA, n (%) | |||||
| Occurrence of procedural complications* | 200/1285 (16) | 202/1304 (16) | OR | 1.01 (0.98 to 1.04) | 0.97 (0.94 to 1.01) |
| Dissection† | 28/1248 (2.2) | 22/1282 (1.7) | OR | 0.96 (0.89 to 1.05) | 0.96 (0.88 to 1.05) |
| Perforation† | 23/1248 (1.8) | 25/1282 (2.0) | OR | 1.01 (0.93 to 1.09) | 1.01 (0.93 to 1.10) |
| Embolus new territory† | 69/1248 (5.5) | 64/1272 (5.0) | OR | 0.99 (0.94 to 1.04) | 0.99 (0.94 to 1.04) |
| Distal thrombus† | 1931248 (16) | 205/1274 (16) | OR | 1.02 (0.99 to 1.05) | 1.04 (1.00 to 1.07) |
| Vasospasm† | 81/1248 (6.5) | 73/1282 (5.7) | OR | 0.98 (0.93 to 1.02) | 0.98 (0.93 to 1.03) |
| Workflow outcomes | |||||
| Number of attempts, median (IQR)† | 2.0 (1.0–3.0), 1127 | 2.0 (1.0–3.0), 1146 | β | 0.017 (−0.002 to 0.036) | 0.02 (−0.01 to 0.04) |
| Duration procedure, (min), mean (SD)‡ |
72 (35), 1178 | 67 (34), 1228 | β | −0.84 (−1.22 to -0.46) | −1.34 (−1.84 to -0.85) |
*Additionally adjusted for: clot burden score; ICA stenosis/dissection/occlusion; antiplatelet/DOAC/coumarin/heparin use.
†Additionally adjusted for: clot burden score; ICA stenosis/dissection/occlusion.
‡Additionally adjusted for: clot burden score; ICA stenosis/dissection/occlusion; ICA stent placement; general anesthesia.
cOR, common odds ratio; DOAC, direct oral anticoagulant; DSA, digital subtraction angiography; EE, effect estimate; eTICI, extended Thrombolysis in Cerebral Infarction; EXPno, experience number; ICA, internal carotid artery; ICH, intracranial hemorrhage; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; SAE, serious adverse event.