Comparison of clinical outcomes in patients with acute ischemic strokes treated with mechanical thrombectomy using either Solumbra or ADAPT techniques

2015 ◽  
Vol 8 (11) ◽  
pp. 1123-1128 ◽  
Author(s):  
Josser E Delgado Almandoz ◽  
Yasha Kayan ◽  
Mark L Young ◽  
Jennifer L Fease ◽  
Jill M Scholz ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Independent Predictor ◽  
National Institutes Of Health ◽  
Good Clinical Outcome ◽  
Anterior Circulation ◽  
First Pass ◽  
Symptomatic Intracranial Hemorrhage

PurposeTo compare rates of symptomatic intracranial hemorrhage (SICH) and good clinical outcome at 90 days in patients with ischemic strokes from anterior circulation emergent large vessel occlusions (ELVO) treated with mechanical thrombectomy using either Solumbra or A Direct Aspiration first-Pass Thrombectomy (ADAPT) techniques.MethodsWe compared clinical characteristics, procedural variables, and clinical outcomes in patients with anterior circulation ELVOs treated with mechanical thrombectomy using either a Solumbra or ADAPT technique at our institution over a 38-month period. SICH was defined using the SITS-MOST criteria. A good clinical outcome was defined as a modified Rankin Scale score of 0–2 at 90 days.ResultsOne hundred patients were included, 55 in the Solumbra group and 45 in the ADAPT group. Patients in the ADAPT group had higher National Institutes of Health Stroke Scale (NIHSS) (19.2 vs 16.8, p=0.02) and a higher proportion of internal carotid artery terminus thrombi (42.2% vs 20%, p=0.03) than patients in the Solumbra group. Patients in the ADAPT group had a trend toward a lower rate of SICH than patients in the Solumbra group (2.2% vs 12.7%, p=0.07). Patients in the ADAPT group had a significantly higher rate of good clinical outcome at 90 days than patients in the Solumbra group (55.6% vs 30.9%, p=0.015). Use of the ADAPT technique (OR 6 (95% CI 1.0 to 31.2), p=0.049) was an independent predictor of a good clinical outcome at 90 days in our cohort.ConclusionsIn our cohort, the ADAPT technique was associated with significantly higher good clinical outcomes at 90 days in patients with acute ischemic stroke due to anterior circulation ELVOs treated with mechanical thrombectomy.

Tandem stents thrombectomy as a rescue treatment for refractory large vessel occlusions

2020 ◽  
Vol 13 (1) ◽  
pp. 33-38
Author(s):  
Haowen Xu ◽  
Shanling Peng ◽  
Tao Quan ◽  
Yongjie Yuan ◽  
Zibo Wang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
National Institutes Of Health ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Good Clinical Outcome ◽  
Vessel Occlusion ◽  
Nihss Score ◽  
Rescue Treatment

BackgroundMechanical thrombectomy with a stent retriever (SR) and/or aspiration is the 'gold standard' for the treatment of acute ischemic stroke due to large vessel occlusion (LVO). However, sometimes clots may not be retrievable with a single SR alone or combined with aspiration.ObjectiveTo assess the safety and efficacy of a novel tandem stents thrombectomy (TST) technique as a rescue treatment for acute LVO that is refractory to conventional attempts.MethodsAll patients treated with the TST technique as rescue treatment after failure of conventional attempts were retrospectively reviewed. The postprocedural angiographic and clinical outcome, including modified Thrombolysis in Cerebral infarction (mTICI) grade, National Institutes of Health Stroke Scale (NIHSS) score, and modified Rankin Scale (mRS) score, was assessed.ResultsNine patients (mean age, 65.2 years; median NIHSS score 18) with middle cerebral artery M1 segment (n=6) and terminal internal carotid artery (n=3) occlusions were included in the study. The TST technique was performed as a rescue treatment after unsuccessful stent thrombectomy alone (four cases) and stent thrombectomy plus aspiration (five cases). Successful recanalization (mTICI 2b/3) was achieved in all patients. No procedure-related complications occurred except reversible vasospasms were observed in three patients and one patient developed hemorrhage transformation after the procedure, but was asymptomatic. Three patients had good clinical outcome (mRS score 0–2 at 90 days). Two patients (22.2%) died.ConclusionsThe TST technique seems to be a safe and effective rescue treatment for acute LVO that is refractory to conventional attempts.

scholarly journals Efficacy of Mechanical Thrombectomy using Penumbra ACETM Aspiration Catheter Compared to Stent Retriever SolitaireTM FR in Patients with Acute Ischemic Stroke

2021 ◽  
Vol 11 (4) ◽  
pp. 504
Author(s):  
Dalibor Sila ◽  
Markus Lenski ◽  
Maria Vojtková ◽  
Mustafa Elgharbawy ◽  
František Charvát ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Mechanical Thrombectomy ◽  
Binary Logistic Regression ◽  
Stent Retriever ◽  
Good Clinical Outcome ◽  
Significant Difference ◽  
Aspiration Technique

Background: Mechanical thrombectomy is the standard therapy in patients with acute ischemic stroke (AIS). The primary aim of our study was to compare the procedural efficacy of the direct aspiration technique, using Penumbra ACETM aspiration catheter, and the stent retriever technique, with a SolitaireTM FR stent. Secondarily, we investigated treatment-dependent and treatment-independent factors that predict a good clinical outcome. Methods: We analyzed our series of mechanical thrombectomies using a SolitaireTM FR stent and a Penumbra ACETM catheter. The clinical and radiographic data of 76 patients were retrospectively reviewed. Using binary logistic regression, we looked for the predictors of a good clinical outcome. Results: In the Penumbra ACETM group we achieved significantly higher rates of complete vessel recanalization with lower device passage counts, shorter recanalization times, shorter procedure times and shorter fluoroscopy times (p < 0.001) compared to the SolitaireTM FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, p = 0.756). Predictors of a good clinical outcome were lower initial NIHSS scores, pial arterial collateralization on admission head CT angiography scan, shorter recanalization times and device passage counts. Conclusions: The aspiration technique using Penumbra ACETM catheter is comparable to the stent retriever technique with SolitaireTM FR regarding clinical outcomes.

Mechanical thrombectomy for anterior circulation stroke: 5-year experience in a statewide service with differences in pretreatment time metrics across two hospitals sites

2016 ◽  
Vol 9 (6) ◽  
pp. 535-540 ◽  
Author(s):  
Ruchi Kabra ◽  
Timothy J Phillips ◽  
Jacqui-Lyn Saw ◽  
Constantine C Phatouros ◽  
Tejinder P Singh ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Mechanical Thrombectomy ◽  
Stroke Onset ◽  
Anterior Circulation ◽  
Stroke Treatment ◽  
Patient Demographics ◽  
Organizational Differences ◽  
Tertiary Hospitals ◽  
Pretreatment Time

ObjectiveTo audit our institutional mechanical thrombectomy (MT) outcomes for acute anterior circulation stroke and examine the influence of workflow time metrics on patient outcomes.MethodsA database of 100 MT cases was maintained throughout May 2010—February 2015 as part of a statewide service provided across two tertiary hospitals (H1 and H2). Patient demographics, stroke and procedural details, blinded angiographic outcomes, and 90-day modified Rankin Scale (mRS) scores were recorded. The following time points in stroke treatment were recorded: stroke onset, hospital presentation, CT imaging, arteriotomy, and recanalization. Statistical analysis of outcomes, predictors of outcome, and differences between the hospitals was carried out.ResultsThrombolysis in Cerebral Infarction (TICI) 2b/3 reperfusion was 79%. Forty-nine per cent of patients had good clinical outcomes (mRS 0–2). In a subgroup analysis of 76 patients with premorbid mRS 0–1 and first CT performed ≤4.5 h after stroke onset, 60% had good clinical outcomes. Patient and disease characteristics were matched between the two hospitals. H1 had shorter times between hospital presentation and CT (32 vs 55 min, p=0.01), CT and arteriotomy (33 vs 69 min, p=0.00), and stroke onset and recanalization (198 vs 260 min, p=0.00). These time metrics independently predicted good clinical outcome. Median days spent at home in the first 90 days was greater at H1 (61 vs 8, p=0.04) than at H2. A greater proportion of patients treated at H1 were independent (mRS 0–2) at 90 days (54% vs 42%); however, this was not statistically significant (p=0.22).ConclusionsOutcomes similar to randomized controlled trials are attainable in ‘real-world’ settings. Workflow time metrics were independent predictors of clinical outcome, and differed between the two hospitals owing to site-specific organizational differences.

TREVO and Capture LP have equal technical success rates in mechanical thrombectomy of proximal and distal anterior circulation occlusions

2016 ◽  
Vol 9 (7) ◽  
pp. 644-649 ◽  
Author(s):  
Sara Protto ◽  
Juha-Pekka Pienimäki ◽  
Janne Seppänen ◽  
Ira Matkaselkä ◽  
Jyrki Ollikainen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Mechanical Thrombectomy ◽  
Randomized Study ◽  
Success Rates ◽  
Technical Success ◽  
Good Clinical Outcome ◽  
Anterior Circulation ◽  
Excellent Outcome ◽  
Proximal Internal Carotid Artery ◽  
Device Selection

PurposeMechanical thrombectomy (MT) is a proven method to treat large vessel occlusions in acute anterior circulation stroke. We compared the technical, imaging, and clinical outcomes of MT performed with either TREVO or Capture LP devices.MethodsThere were 42 and 43 patients in the TREVO and Capture LP groups, respectively. Baseline variables, technical outcome (Thrombolysis In Cerebral Infarction, TICI), 24 hours imaging outcome, and 3-month clinical outcome (modified Rankin Scale, mRS) were prospectively recorded. The patients were stratified according to clot location, groups compared, and logistic regression models devised to study the effect of device selection on the clinical outcome.ResultsThe technical success rates were equal in both proximal (internal carotid artery and proximal M1 segment) and distal occlusions (distal M1 and M2 segments). The proportion of TICI 2b or 3 was 96% and 87% with TREVO and 87% and 89% with Capture LP (p=0.25 and p=0.80, respectively). Device selection did not significantly predict good clinical outcome (mRS ≤2) in either proximal or distal occlusions. In multivariate analysis, selecting Capture LP borderline significantly increased the odds of an excellent outcome close to sixfold both in proximal and distal occlusions (OR 6.7, 95% CI 0.82 to 53.7, p=0.08 and OR 5.7, 95% CI 0.88 to 37.8, p=0.07, respectively).ConclusionsTREVO and Capture LP perform equally well in proximal and distal occlusions in the anterior circulation when technical and good clinical outcome are considered. Capture LP may have a small advantage in reaching mRS ≤1 at 3 months. However, this needs to be confirmed in a randomized study.

scholarly journals Intracranial mechanical thrombectomy of large vessel occlusions in the posterior circulation using SAVE

2019 ◽  
Author(s):  
Volker Maus ◽  
Hanna Styczen ◽  
Jan Liman ◽  
Ilko Maier ◽  
Alex Brehm ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Posterior Circulation ◽  
Large Vessel ◽  
Time Interval ◽  
Anterior Circulation ◽  
Primary Endpoints ◽  
First Pass ◽  
Secondary Endpoints ◽  
Symptomatic Intracranial Hemorrhage ◽  
Number Of Passes

Abstract Background Mechanical thrombectomy (MT) using stent retriever assisted vacuum-locked extraction (SAVE) is a promising method for anterior circulation strokes. We present our experience with SAVE for large vessel occlusions (LVO) of the posterior circulation. Methods We retrospectively analyzed 66 consecutive MT patients suffering from LVO of the posterior circulation. Primary endpoints were first-pass and overall complete/near complete reperfusion, defined as a modified thrombolysis in cerebral infarction (mTICI) score of 2c and 3. Secondary endpoints contained number of passes, time interval from groin puncture to reperfusion and rate of postinterventional symptomatic intracranial hemorrhage (sICH). Results Median age was 75 years (interquartile range (IQR) 54 – 81 years). Baseline median National Institutes of Health stroke scale (NIHSS) was 13 (IQR 8 – 21). Fifty-five (83%) patients had LVO of the basilar artery and 11 (17%) of the posterior cerebral artery. Eighteen (27%) patients were treated with SAVE and 21 (32%) with aspiration only. First pass mTICI2c or 3 and overall mTICI2c or 3 were documented in 11/18 (61%) and 14/18 (78%) with SAVE and in 4/21 (19%) and 13/21 (33%) with aspiration only. Median attempt was 1 (IQR 1 – 2) with SAVE and 2 (IQR 1 – 4) with aspiration (p=0.0249). Median groin to reperfusion time did not differ significantly between groups. The rate of sICH was 5% without any complications in the SAVE cohort. Conclusion Mechanical thrombectomy of posterior large vessel occlusions with SAVE is feasible, safe, and effective with high rates of near-complete and complete reperfusion.

scholarly journals Increased Postoperative Fasting Glucose Is Associated With Unfavorable Outcomes in Patients Treated With Mechanical Thrombectomy Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Zongjie Shi ◽  
Shunyuan Guo ◽  
Jie Pan ◽  
Chao Xu ◽  
Yu Geng ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Primary Outcome ◽  
Mechanical Thrombectomy ◽  
Fasting Glucose ◽  
Independent Predictor ◽  
Secondary Outcome ◽  
Vessel Occlusion ◽  
Glucose Levels ◽  
Increased Risk ◽  
Symptomatic Intracranial Hemorrhage

Background and objective: Hyperglycemia on admission was associated with worse clinical outcomes after mechanical thrombectomy (MT) of acute ischemic stroke (AIS). We evaluated whether increased postoperative fasting glucose (PFG) was also related to poor clinical outcomes in patients who underwent MT treatment.Methods: Consecutive patients with large vessel occlusion underwent MT in our center were included. Admission glucose and fasting glucose levels after MT treatment were evaluated. Primary outcome was 90-day unfavorable outcomes (modified Rankin Scale score of 3–6). Secondary outcome was the rate of symptomatic intracranial hemorrhage (sICH) after MT treatment. The association of PFG and 90-day clinical outcome after MT treatment was determined using logistic regression analyses.Results: One hundred twenty seven patients were collected. The median postoperative fasting glucose level was 6.27 mmol/L (IQR 5.59–7.62). Fourteen patients (11.02%) had sICH, and fifty-eight patients (45.67%) had unfavorable outcomes at 90-day after MT. After adjustment for potential confounding factors, PFG level was an independent predictor of 90-day unfavorable outcome (OR 1.265; 95% CI 1.017–1.575; p = 0.035) and sICH (OR 1.523; 95% CI 1.056–2.195; p = 0.024) after MT. In addition, older age, higher baseline NIHSS score, and higher postoperative NLR were also associated with unfavorable outcomes at 90-day after MT treatment.Conclusions: Increased PFG is associated with unfavorable outcomes at 90-day and an increased risk of sICH in patients underwent MT treatment.

scholarly journals Clinical Outcome After Endovascular Thrombectomy in 3 Triage Concepts

Stroke ◽  
2021 ◽  
Author(s):  
Fatih Seker ◽  
Jens Fiehler ◽  
Markus A. Möhlenbruch ◽  
Christian Herweh ◽  
Fabian Flottmann ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Primary Outcome Measure ◽  
National Institutes Of Health ◽  
Stroke Onset ◽  
Treatment Quality ◽  
Secondary Outcome ◽  
Good Clinical Outcome ◽  
Anterior Circulation ◽  
Stroke Treatment ◽  
Significant Difference

Background and Purpose: NEUROSQUAD (Stroke Treatment: Quality and Efficacy in Different Referral Systems) is a prospective, observational, bicenter study comparing 3 triage pathways in endovascular stroke treatment: mothership, drip and ship (DS), and transferring a neurointerventionalist to a remote hospital for thrombectomy (drive the doctor [DD]). Methods: Patients with anterior circulation stroke and premorbid modified Rankin Scale (mRS) score 0–3 who underwent thrombectomy within 24 hours after stroke onset were included. Primary outcome measure was good clinical outcome defined as 90-day mRS score 0–2 or clinical recovery to the status before stroke onset (ie, equal premorbid mRS and 90-day mRS). Secondary outcome measures were successful reperfusion, National Institutes of Health Stroke Scale at discharge, and mRS shift. Results: In total, 360 patients were included in this study, of whom 111 patients (30.8%) were in the mothership group, 204 patients (56.7%) were in the DS group, and 45 patients (12.5%) were in the DD group. Good clinical outcome was achieved similarly in all three groups (mothership, 45.9%; DS, 43.1%; DD, 40.0%; P =0.778). Likewise, frequency of successful reperfusion was similar in all three groups (mothership, 86.5%; DS, 85.3%; DD, 82.2%; P =0.714). There was no significant difference among the groups regarding the National Institutes of Health Stroke Scale at discharge ( P =0.115) and mRS shift ( P =0.342). In the multivariate analysis, triage concept was not an independent predictor of good outcome (unadjusted odds ratio, 0.89 [CI, 0.64–1.23]; P =0.479). Conclusions: Our data suggest that clinical outcome after thrombectomy is similar in mothership, DS, and DD. Hence, DD can be a valuable triage option in acute stroke treatment.

Abstract W MP9: Early Reperfusion with a Stentriever Device: A First Step to Superior Outcomes in TREVO2

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
David S Liebeskind ◽  
Fabien Scalzo ◽  
Nerses Sanossian ◽  
Bin Xiang ◽  
Rishi Gupta ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Blood Volume ◽  
Cerebral Blood Volume ◽  
Arterial Phase ◽  
Good Clinical Outcome ◽  
Anterior Circulation ◽  
Early Reperfusion ◽  
First Pass ◽  
Device Deployment ◽  
The Impact

Background: TREVO2 showed better outcomes after thrombectomy with the Trevo stentriever compared to Merci. We studied the impact of early reperfusion up to the first pass to explore the impact of device deployment on subsequent outcomes. Methods: Reperfusion during stentriever deployment and after the first pass in both arms (Merci and Trevo) of TREVO2 was quantified by cerebral blood volume (CBV) delivered to the downstream territory using perfusion angiography (perfAngio) software. Automatic, normalized extraction of CBV distal to anterior circulation occlusions was obtained from AP projections during arterial phase. CBV during deployment, after the first pass and sum of CBV up to the first pass (Σ CBV) were analyzed with respect to angiographic and clinical outcomes. Results: CBV was measured from DSA in 83 (34 Trevo, 49 Merci) occlusions in TREVO2. Clinical variables of this cohort were similar between device arms and with respect to others in the trial. During stentriever deployment, 29/34 cases demonstrated delivery of blood volume to downstream territory, averaging about 10% of the amount delivered after the first pass. Change in CBV from deployment to the first pass in 26/29 cases showed a further increase in 15 and decrease in 11, with re-occlusion in 4. CBV only after the first pass did not differ between Merci and Trevo (p=NS). CBV after first pass (p=0.06) and Σ CBV (p=0.03) both predict successful revascularization and demonstrate a moderate correlation with the time to sustained TICI 2a flow. Logistic regression analysis revealed that Σ CBV is a predictor of good clinical outcome (mRS 0-2) at day 90 (p=0.08) and use of Trevo further impacts outcome. Conclusions: Stentriever deployment achieves delivery of blood volume to the ischemic bed downstream. The amount of CBV delivered up to the first pass influences revascularization and good clinical outcomes.

Differential effect of mechanical thrombectomy and intravenous thrombolysis in atrial fibrillation associated stroke

2020 ◽  
pp. neurintsurg-2020-016720
Author(s):  
Feras Akbik ◽  
Ali Alawieh ◽  
C Michael Cawley ◽  
Brian M Howard ◽  
Frank C Tong ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Intracranial Hemorrhage ◽  
Functional Outcomes ◽  
Mechanical Thrombectomy ◽  
Intravenous Thrombolysis ◽  
Anterior Circulation ◽  
Increased Risk ◽  
First Pass

BackgroundAtrial fibrillation (AF) associated ischemic stroke has worse functional outcomes, less effective recanalization, and increased rates of hemorrhagic complications after intravenous thrombolysis (IVT). Limited data exist about the effect of AF on procedural and clinical outcomes after mechanical thrombectomy (MT).ObjectiveTo determine whether recanalization efficacy, procedural speed, and clinical outcomes differ in AF associated stroke treated with MT.MethodsWe performed a retrospective cohort study of the Stroke Thrombectomy and Aneurysm Registry (STAR) from January 2015 to December 2018 and identified 4169 patients who underwent MT for an anterior circulation stroke, 1517 (36.4 %) of whom had comorbid AF. Prospectively defined baseline characteristics, procedural outcomes, and clinical outcomes were reported and compared.ResultsAF predicted faster procedural times, fewer passes, and higher rates of first pass success on multivariate analysis (p<0.01). AF had no effect on intracranial hemorrhage (aOR 0.69, 95% CI 0.43 to 1.12) or 90-day functional outcomes (aOR 1.17, 95% CI 0.91 to 1.50) after MT, although patients with AF were less likely to receive IVT (46% vs 54%, p<0.0001).ConclusionsIn patients treated with MT, comorbid AF is associated with faster procedural time, fewer passes, and increased rates of first pass success without increased risk of intracranial hemorrhage or worse functional outcomes. These results are in contrast to the increased hemorrhage rates and worse functional outcomes observed in AF associated stroke treated with supportive care and or IVT. These data suggest that MT negates the AF penalty in ischemic stroke.

Association of clot burden score with radiographic and clinical outcomes following Solitaire stent retriever thrombectomy: analysis of the SWIFT PRIME trial

2016 ◽  
Vol 9 (10) ◽  
pp. 929-932 ◽  
Author(s):  
Maxim Mokin ◽  
Elad I Levy ◽  
Adnan H Siddiqui ◽  
Mayank Goyal ◽  
Raul G Nogueira ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Stent Retriever ◽  
Study Cohort ◽  
Prime Trial ◽  
Good Clinical Outcome ◽  
Anterior Circulation ◽  
Clot Burden ◽  
Proximal Occlusion ◽  
The Relationship

BackgroundThe clot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. CBS is based on the presence or absence of contrast opacification on CT angiography (CTA). Its value in predicting radiographic and clinical outcomes in patients given endovascular stroke therapy remains unknown.ObjectiveTo evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial.MethodsCBS was calculated for the endovascular arm (IV tissue plasminogen activator plus Solitaire stent retriever) of SWIFT PRIME using baseline CTA. The cohort of 69 patients was divided into three groups according to their CBS values: CBS 0–5 (n=14), CBS 6–7 (n=23), and CBS 8–9 (n=32).ResultsThe mean age of the 69 patients who formed the study cohort was 63.2±13.1 years, mean National Institutes of Health Stroke Scale score was 16.8±4.5, and 55% of the patients were male. There was no difference in clinical characteristics among the three groups, except for the baseline Alberta Stroke Program Early CT Score (p=0.049). The site of proximal occlusion varied significantly among the three groups (p<0.001). Rates of successful recanalization (TICI 2b/3), complete recanalization (TICI 3 only) and of good clinical outcome at 3 months were similar among the three groups (p=0.24, p=0.35, and p=0.52, respectively).ConclusionsThe combination of IV thrombolysis and stent retriever thrombectomy with the Solitaire device is highly effective in achieving successful recanalization and a good clinical outcome throughout the entire range of CBS values.

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