1.Erratum: Susceptibility Vessel Sign in the ASTER Trial: Higher Recanalization Rate and More Favourable Clinical Outcome after First Line Stent Retriever Compared to Contact Aspiration.
Romain BOURCIER ; Mickael MAZIGHI ; Julien LABREUCHE ; Robert FAHED ; Raphael BLANC ; Benjamin GORY ; Alain DUHAMEL ; Gaultier MARNAT ; Suzana SALEME ; Vincent COSTALAT ; Serge BRACARD ; Hubert DESAL ; Arturo CONSOLI ; Michel PIOTIN ; Bertrand LAPERGUE
Journal of Stroke 2018;20(3):416-416
On page 271, in Table 1, the value ‘1115 (65??51)’ of subgroup ‘Imaging to groin puncture’ and column heading ‘SVS (??’ was input incorrectly. The correct value is ‘115 (65??51).’
2.Susceptibility Vessel Sign in the ASTER Trial: Higher Recanalization Rate and More Favourable Clinical Outcome after First Line Stent Retriever Compared to Contact Aspiration.
Romain BOURCIER ; Mickael MAZIGHI ; Julien LABREUCHE ; Robert FAHED ; Raphael BLANC ; Benjamin GORY ; Alain DUHAMEL ; Gaultier MARNAT ; Suzana SALEME ; Vincent COSTALAT ; Serge BRACARD ; Hubert DESAL ; Arturo CONSOLI ; Michel PIOTIN ; Bertrand LAPERGUE
Journal of Stroke 2018;20(2):268-276
BACKGROUND AND PURPOSE: In the Aspiration vs. Stent Retriever for Successful Revascularization (ASTER) trial, which evaluated contact aspiration (CA) versus stent retriever (SR) use as first-line technique, the impact of the susceptibility vessel sign (SVS) on magnetic resonance imaging (MRI) was studied to determine its influence on trial results. METHODS: We included patients having undergone CA or SR for M1 or M2 occlusions, who were screened by MRI with T2* gradient recalled echo. Occlusions were classified as SVS (+) or SVS (–) in each randomization arm. Modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3 revascularization rates were recorded and clinical outcomes assessed by the overall distribution of modified Rankin scale (mRS) at 90 days. RESULTS: Among the 202 patients included, 143 patients were SVS (+) (70.8%; 95% confidence interval [CI], 64.5% to 77.1%). Overall, there was no difference in angiographic and clinical outcomes according to SVS status. However, compared to SR, CA achieved a lower mTICI 2c/3 rate in SVS (+) patients (risk ratio [RR] for CA vs. SR, 0.60; 95% CI, 0.51 to 0.71) but not in SVS (–) (RR, 1.11; 95% CI, 0.69 to 1.77; P for interaction=0.018). A significant heterogeneity in favor of superiority of first-line SR strategy in SVS (+) patients was also found regarding the overall mRS distribution (common odds ratio for CA vs. SR, 0.40 vs. 1.32; 95% CI, 0.21 to 0.74 in SVS (+) vs. 95% CI, 0.51 to 3.35 in SVS (–); P for interaction=0.038). CONCLUSIONS: As a first line strategy, SR achieved higher recanalization rates and a more favourable clinical outcome at 3 months compared to CA when MRI shows SVS within the thrombus.
Arm
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Cerebral Infarction
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Humans
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Magnetic Resonance Imaging
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Odds Ratio
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Population Characteristics
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Random Allocation
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Stents*
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Thrombectomy
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Thrombosis