Outcome comparison between SR alone first-line and SR+CA first-line groups
| Outcomes | SR alone first-line | SR+CA first-line | Unadjusted model | Adjusted model 1* | Adjusted model 2† | |||
| Effect size (95% CI) | P value | Effect size (95% CI) | P value | Effect size (95% CI) | P value | |||
| Primary outcome | ||||||||
| Successful recanalisation after first technique alone, n(%)‡ | 714 (66.8) | 108 (65.9) | 0.96 (0.68 to 1.36) | 0.812 | 0.83 (0.58 to 1.20) | 0.323 | 0.85 (0.60 to 1.22) | 0.376 |
| Secondary outcomes | ||||||||
| Complete recanalisation after first technique alone, n(%)§ | 560 (52.4) | 84 (51.2) | 0.95 (0.69 to 1.33) | 0.781 | 0.85(0.61-1.20) | 0.357 | 0.86 (0.62 to 1.21) | 0.392 |
| First-pass successful recanalisation, n (%)ࠠ | 536 (50.1) | 81 (49.4) | 0.97 (0.70 to 1.35) | 0.858 | 0.93 (0.67 to 1.30) | 0.665 | 0.95 (0.68 to 1.33) | 0.771 |
| First-pass complete recanalisation, n (%)§†† | 371 (34.8) | 56 (34.2) | 0.97 (0.69 to 1.38) | 0.876 | 0.93 (0.65 to 1.32) | 0.666 | 0.94 (0.66 to 1.34) | 0.731 |
| Number of MT attempts, median (IQR） | 2 (1–2) | 3 (2–4) | 1.81 (1.59 to 2.03) | <0.001 | 1.77 (1.55 to 1.99) | <0.001 | 1.76 (1.54 to 1.98) | <0.001 |
| Procedure duration, min, median (IQR） | 80 (50–122) | 86 (60–129) | 5.77 (−3.90 to 15.45) | 0.242 | 10.76 (1.08 to 20.43) | 0.029 | 9.96 (0.22 to 19.70) | 0.045 |
| Successful recanalisation after all procedures, n (%) | 975 (91.2) | 150 (91.5) | 1.03 (0.57 to 1.86) | 0.915 | 1.10 (0.61 to 2.00) | 0.757 | 1.12 (0.61 to 2.03) | 0.719 |
| Complete recanalisation after all procedures, n (%) | 750 (70.2) | 111 (67.7) | 0.89 (0.63 to 1.27) | 0.520 | 0.86 (0.60 to 1.23) | 0.411 | 0.87 (0.61 to 1.25) | 0.461 |
| Rescue treatment | ||||||||
| Switching to other thrombectomy technique after 3 attempts, n (%) | 49 (4.6) | 11 (6.7) | 1.50 (0.76 to 2.94) | 0.242 | 1.27 (0.64 to 2.54) | 0.492 | 1.24 (0.62 to 2.48) | 0.538 |
| Balloon angioplasty/stenting, n (%) | 160 (15.0) | 18 (11.0) | 0.70 (0.42 to 1.18) | 0.178 | 0.91 (0.53 to 1.56) | 0.731 | 0.85 (0.50 to 1.45) | 0.554 |
| NIHSS score changed at 24 hours, median (IQR） | −5 (−10 to 0) | −4 (−9 to −1) | 0.73 (−0.77 to 2.23) | 0.338 | 1.15 (−0.36 to 2.66) | 0.135 | 1.09 (−0.42 to 2.61) | 0.157 |
| 90-day mRS, median (IQR） | 3 (0–5) | 3 (0–5) | 0.99 (0.91 to 1.08) | 0.493 | 1.12 (0.84 to 1.51) | 0.445 | 1.10 (0.82 to 1.48) | 0.527 |
| 90-day mRS 0–1, n (%) | 423 (39.6) | 66 (40.2) | 1.03 (0.74 to 1.44) | 0.870 | 1.01 (0.71 to 1.43) | 0.957 | 1.03 (0.73 to 1.44) | 0.883 |
| 90-day mRS 0–2, n (%) | 468 (43.8) | 71 (43.3) | 0.98 (0.70 to 1.37) | 0.907 | 0.96 (0.68 to 1.36) | 0.812 | 0.97 (0.70 to 1.36) | 0.877 |
| 90-day mRS 0–3, n (%) | 582 (54.4) | 92 (56.1) | 1.07 (0.77 to 1.49) | 0.693 | 1.06 (0.75 to 1.50) | 0.729 | 1.07 (0.76 to 1.49) | 0.714 |
| Safety outcomes | ||||||||
| Intraprocedure embolisation, n (%) | 57 (5.3) | 13 (7.9) | 1.53 (0.82 to 2.86) | 0.181 | 1.24 (0.65 to 2.35) | 0.519 | 1.19 (0.63 to 2.28) | 0.591 |
| Parenchymal haemorrhage type 1, n (%)¶ | 52 (5.0) | 9 (5.7) | 1.13 (0.55 to 2.35) | 0.735 | 1.09 (0.52 to 2.28) | 0.828 | 1.07 (0.51 to 2.25) | 0.857 |
| Parenchymal haemorrhage type 2, n (%)¶ | 43 (4.2) | 7 (4.4) | 1.06 (0.47 to 2.41) | 0.885 | 1.04 (0.45 to 2.41) | 0.925 | 0.99 (0.43 to 2.28) | 0.987 |
| Symptomatic intracranial haemorrhage, n (%)** | 70 (6.8) | 14 (8.9) | 1.33 (0.73 to 2.42) | 0.352 | 1.32 (0.71 to 2.46) | 0.374 | 1.28 (0.70 to 2.36) | 0.427 |
| Any intracranial haemorrhage, n (%)¶ | 225 (21.7) | 42 (26.4) | 1.29 (0.88 to 1.89) | 0.189 | 1.25 (0.84 to 1.85) | 0.274 | 1.22 (0.82 to 1.79) | 0.326 |
| 90-day mRS 6, n (%) | 186 (17.4) | 20 (12.2) | 0.66 (0.40 to 1.08) | 0.098 | 0.68 (0.41 to 1.13) | 0.137 | 0.68 (0.41 to 1.12) | 0.127 |
Bold values indicate statistical significance
*All the baseline variables with p<0.05 in univariable analysis between both groups including age, atrial fibrillation, tandem occlusion, pretreatment with IVT, general anaesthesia and heparin during the procedure were adjusted.
†Adjusted for the propensity score.
‡Defined as mTICI 2b–3.
§Defined as mTICI 3.
¶Thirty-nine missing data.
**Forty-eight missing data.
†† Two missing data.
CA, contact aspiration; IVT, intravenous thrombolysis; mRS, modified Rankin Scale; MT, mechanical thrombectomy; mTICI, modified Thrombolysis in Cerebral Infarction; NIHSS, National Institutes of Health Stroke Scale; SR, stent retriever.