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. 2024 Mar 30;10(7):e28873.
doi: 10.1016/j.heliyon.2024.e28873. eCollection 2024 Apr 15.

Impact of stent retriever size on clinical outcomes in the RECO registry

Yunlong Ding  1 , Xiaoxiao Mao  2 , Lei Bao  3 , Tingting Zhai  1 , Wenjuan Wang  1 , Zhiqun Gu  1 , Yan Liu  1 , Jiali Niu  4
Affiliations

Impact of stent retriever size on clinical outcomes in the RECO registry

Yunlong Ding et al. Heliyon. .

Abstract

Objective: In the RECO study, we investigated the impact of the operator's choice of stent retriever size on patients with internal carotid artery (ICA) occlusion.

Methods: Data from the RECO Registry, a prospective multicentre study, were utilized. Patients who underwent mechanical thrombectomy (MT) were divided according to the size of the stent into the RECO 4 × 20 group, the RECO 5 × 30 group and the RECO 6 × 30 group. The outcome measures assessed in the study were the 3-month modified Rankin Scale (mRS) score, occurrence of any intracranial haemorrhage (aICH), workflow timing, recanalization success rate, number of attempts, and all-cause mortality within a 3-month period.

Results: Analysis was conducted on a total of 89 patients with ICA occlusion. RECO 4 × 20, 5 × 30, and 6 × 30 stent retrievers were used in 19 (21.3%), 52 (58.4%), and 18 (20.2%) patients, respectively. The demographic and baseline characteristics showed considerable similarity across the three groups. The puncture-to-recanalization time of the RECO 6 × 30 group [56.5 min (IQR, 41.5-80.8)] was significantly shorter than that of the RECO 4 × 20 group [110 min (IQR, 47-135)]. In 10 out of 18 patients (55.6%), the RECO 6 × 30 stent retriever achieved reperfusion (modified Thrombolysis in Cerebral Infarction [mTICI] score 2b-3) after the initial attempt, surpassing the rates of 31.6% in the RECO 4 × 20 group and 32.7% in the RECO 5 × 30 group. In the RECO 4 × 20 group, the median number of passes was 2 (IQR, 1-3); in the RECO 5 × 30 group, it was 2 (IQR, 1-3); and in the RECO 6 × 30 groups, it was 1 (IQR, 1-2.5). There were no statistically significant differences observed among the three groups concerning aICH or good outcomes (mRS score 0-2).

Conclusion: Our study demonstrated the practical implications of stent-retriever size selection in the context of the MT for ICA occlusion. The routine use of a RECO 6 × 30 stent retriever holds the potential for early revascularization in clinical practice. The significant reduction in the puncture-to-reperfusion time and the greater first-pass effect associated with this stent size underscore its efficiency in treating ICA occlusion.

Keywords: Acute ischaemic stroke; Internal carotid artery; Mechanical thrombectomy; Stents.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Yunlong Ding reports financial support was provided by Taizhou Municipal Science and Technology Bureau (CN). Yunlong Ding reports financial support was provided by the Research Fund of Jingjiang People's Hospital.

Figures

Fig. 1
Fig. 1
Distribution of modified Rankin Scale scores at 3 months according to the RECO stent retriever size.
See this image and copyright information in PMC

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