BACKGROUND Stent retriever thrombectomy has been regarded as the standard treatment for acute intracranial large artery occlusion. As fast recanalization is the most important factor for favorable outcomes in patients with stroke, defining the etiology is important for the treatment of acute large vessel occlusion. We aimed to investigate whether full-length stent visibility during thrombectomy could provide information on the stroke etiology or the clot characteristics using the stent strut deformity during thrombectomy. MATERIALS AND METHODS Intra-arterial thrombectomy was performed on 46 patients with Trevo stent as the first endovascular thrombectomy device. Patients were assigned to the full expansion group or the stent deformity group based on the shape of the stent strut during the endovascular procedure. The presence of stent deformity during the procedure, underlying intracranial atherosclerotic stenosis (ICAS), and residual stenosis at the occlusion site on the final conventional angiography, follow-up magnetic resonance angiography, or computed tomography angiography were retrospectively assessed. RESULTS Recanalization without underlying arterial stenosis at the occlusion site was observed in 92.9 % (26/28 patients) and 50.0 % (8/16 patients) of the full expansion and stent deformity groups (p = 0.002), respectively. A significantly lower proportion of patients in the full expansion group demonstrated ICAS-related occlusion compared with that in the stent deformity group (3.6 % vs. 43.8 %, respectively; p = 0.002). CONCLUSIONS The degree of stent expansion during thrombectomy in acute large artery occlusion can be a useful predictor of the stroke etiology and potentially helpful to the operator for endovascular treatment planning.

中文翻译：

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血栓切除术中支架支柱畸形预测急性大动脉闭塞卒中病因的有用性

背景支架取栓术已被视为急性颅内大动脉闭塞的标准治疗方法。由于快速再通是卒中患者获得良好预后的最重要因素，因此明确病因对于治疗急性大血管闭塞很重要。我们的目的是调查血栓切除术期间全长支架的可见性是否可以提供有关卒中病因或血栓切除术期间使用支架支柱畸形的血栓特征的信息。材料与方法 46 名患者使用 Trevo 支架作为第一个血管内取栓装置进行了动脉取栓术。根据血管内手术过程中支架支柱的形状，将患者分为完全扩张组或支架畸形组。对手术过程中支架畸形的存在、潜在的颅内动脉粥样硬化狭窄 (ICAS) 以及最终常规血管造影、随访磁共振血管造影或计算机断层扫描血管造影中闭塞部位的残余狭窄进行了回顾性评估。结果 完全扩张组和支架畸形组中分别有 92.9%（26/28 名患者）和 50.0%（8/16 名患者）（p = 0.002）观察到闭塞部位无潜在动脉狭窄的再通。与支架畸形组相比，完全扩张组中出现 ICAS 相关闭塞的患者比例显着降低（分别为 3.6 % 和 43.8 %；p = 0.002）。