You better hope your doctor has reconciled the two opposite conclusions here and previously. Or don't your doctors even know of these two pieces of research?
Here: Repeat MT
seems to be safe and effective for attaining vessel recanalization.(This only seems to consider recanalization, not what is important to survivors.)
Previous:
More than one clot retrieval attempt after stroke causes decline in functional outcomes
Repeated attempts to retrieve a clot in patients with acute stroke
increased both the rate of emboli to new territory and infarct growth
volume, with an impact on functional outcomes even when recanalization
was successful.
The latest here:
Repeated Mechanical Endovascular Thrombectomy for Recurrent Large Vessel Occlusion: A Multicenter Experience
Abstract
Background and Purpose:
Mechanical thrombectomy (MT) is now the standard of care for large vessel occlusion (LVO) stroke. However, little is known about the frequency and outcomes of repeat MT (rMT) for patients with recurrent LVO.
Methods:
This is a retrospective multicenter cohort of patients who underwent rMT at 6 tertiary institutions in the United States between March 2016 and March 2020. Procedural, imaging, and outcome data were evaluated. Outcome at discharge was evaluated using the modified Rankin Scale.
Results:
Of 3059 patients treated with MT during the study period, 56 (1.8%) underwent at least 1 rMT. Fifty-four (96%) patients were analyzed; median age was 64 years. The median time interval between index MT and rMT was 2 days; 35 of 54 patients (65%) experienced recurrent LVO during the index hospitalization. The mechanism of stroke was cardioembolism in 30 patients (56%), intracranial atherosclerosis in 4 patients (7%), extracranial atherosclerosis in 2 patients (4%), and other causes in 18 patients (33%). A final TICI recanalization score of 2b or 3 was achieved in all 54 patients during index MT (100%) and in 51 of 54 patients (94%) during rMT. Thirty-two of 54 patients (59%) experienced recurrent LVO of a previously treated artery, mostly the pretreated left MCA (23 patients, 73%). Fifty of the 54 patients (93%) had a documented discharge modified Rankin Scale after rMT: 15 (30%) had minimal or no disability (modified Rankin Scale score ≤2), 25 (50%) had moderate to severe disability (modified Rankin Scale score 3–5), and 10 (20%) died.
Conclusions:
Almost
2% of patients treated with MT experience recurrent LVO, usually of a
previously treated artery during the same hospitalization. Repeat MT
seems to be safe and effective for attaining vessel recanalization, and
good outcome can be expected in 30% of patients.(Is your good outcome
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