Clinical Usefulness of Waiting after Stent Deployment in Mechanical Thrombectomy: Effect of the Clot Integration

Background: Pulling a retriever stent after several minutes of waiting time is a popular technique in mechanical thrombectomy with a stent retriever, but little data exist on the actual effects of waiting after stent deployment. Methods: We conducted a multicenter retrospective study of consecutive 210 patients separated into 2 groups, a waiting after stent deployment group and a nonwaiting group. A comparative analysis was performed in terms of clinical and radiologic outcomes and complications with respect to multiple categories. Results: There were no significant differences in baseline characteristics and clinical outcomes between the 2 groups. However, compared with the nonwaiting group, the waiting group had a higher rate of one-pass procedures, a lower mean number of stent passages, and a shorter procedure time (P = 0.021, 0.014, and 0.004, respectively). The proportion of patients with successful recanalization was also higher in the waiting group (P = 0.038). In multivariate analysis, waiting after stent deployment was a predictive factor for successful recanalization (odds ratio, 1.60; 95% confidence interval, 1.110–2.090; P = 0.02). Conclusions: Waiting after stent deployment can lead to a more successful recanalization with a smaller number of stent passages and less distal emboli. More randomized controlled trials are needed to support these findings.