Ngankou EH, Gory B, Marnat G, et al. - According to findings, the procedural complication rate post-thrombectomy for anterior large vessel occlusions was not negligible. Disability and mortality were evident in relation to embolus to new territories (ENTs) and perforations. Terminal carotid/tandem occlusions were identified as a risk factor.

• Using data from an ongoing prospective multicenter observational registry, a retrospective analysis of 4,029 stroke patients with anterior large vessel occlusions treated with thrombectomy between January 2015 and May 2020 in 18 centers, was conducted.

• Procedural complications were encountered by 7.99%, ENT being the most frequent (5.2%).

• ENTs were predicted by terminal carotid/tandem occlusion (odds ratio [OR], 5) and an increased total number of passes (OR, 1.22), and were linked with worse clinical results, raised mortality, and symptomatic intracerebral hemorrhage.

• Perforations took place in 1.69%, were predicted by terminal carotid/tandem occlusions (39.7% vs 27.6%), and associated with an overall rate of poor outcome of 74.6%.

• Dissections occurred in 1.46% and more frequently developed in younger patients, but did not impact clinical outcome at 90 days.

• Besides dissection, complications were identified to be independent of the thrombectomy technique.