First-Pass Effect in M1-Occlusion Stroke Patients Treated with Combined Stent-Retriever/Large-Bore Distal Aspiration Catheter Thrombectomy

被引：5

作者：

Remollo, S. ^{[1
]}

Werner, M. ^{[1
]}

Blasco, J. ^{[2
]}

Lopez-Rueda, A. ^{[2
]}

San Roman, L. ^{[2
]}

Jimenez-Gomez, E. ^{[3
]}

Rey, I. Bravo ^{[4
]}

Vega, P. ^{[5
]}

Murias, E. ^{[5
]}

Rosati, S. ^{[6
]}

Perez-Garcia, C. ^{[6
]}

Gonzalez, E. ^{[7
]}

Manso, X. ^{[7
]}

Aixut, S. ^{[8
]}

Chaparro, O. Chirife ^{[8
]}

Terceno, M. ^{[9
]}

Bashir, S. ^{[9
]}

Pumar, J. M. ^{[10
]}

Ruiz-Gonzalez, E. ^{[11
]}

Mendez, J. C. ^{[12
]}

Aguilar Tejedor, Y. ^{[13
]}

Zamarro, J. ^{[14
]}

Castano, M. ^{[15
]}

Daunis-I-Estadella, P. ^{[16
]}

Puig, J. ^{[17
,18
]}

机构：

[1] Hosp Badalona Germans Trias & Pujol, Intervent Neuroradiol Unit, Badalona, Spain

[2] Hosp Clin Barcelona, Neurointervent Dept CDI, Barcelona, Spain

[3] Hosp Univ Reina Sofia, Diagnost & Therapeut Neuroradiol Unit, Cordoba, Spain

[4] Hosp Univ Reina Sofia, Neuroradiol Dept, Cordoba, Spain

[5] Hosp Univ Cent Asturias, Radiol Dept, Oviedo, Spain

[6] Hosp Clin Univ San Carlos, Neurointervent Unit, Madrid, Spain

[7] Cruces Univ Hosp, Radiol Dept, Intervent Neuroradiol, Baracaldo, Spain

[8] Hosp Univ Bellvitge, Hosp Llobregat, Neuroradiol Dept, Lhospitalet De Llobregat, Spain

[9] Hosp Univ Girona Doctor Josep Trueta, Dept Neurol, Stroke Unit, Girona, Spain

[10] Complexo Hosp Univ Santiago de Compostela, Neuroradiol Dept, Santiago De Compostela, Spain

[11] Hosp Gen Univ Alicante, Intervent Neuroradiol, Alicante, Spain

[12] Hosp Univ Ramon & Cajal, Intervent Neuroradiol, Madrid, Spain

[13] Hosp Univ Insular Gran Canaria, Radiol Dept, Gran Canaria, Spain

[14] Hosp Clin Univ Virgen de la Arrixaca, Intervent Neuroradiol, Murcia, Spain

[15] Hosp Univ Salamanca, Dept Radiol, Intervent Neuroradiol Unit, Salamanca, Spain

[16] Univ Girona, Dept Comp Sci Appl Math & Stat, Girona, Spain

[17] Hosp Univ Doctor Josep Trueta, Dept Radiol IDI, Girona, Spain

[18] Hosp Univ Doctor Josep Trueta, Inst Invest Biomed Girona, Girona, Spain

来源：

CLINICAL NEURORADIOLOGY | 2023年 / 33卷 / 03期

关键词：

Ischemia; Endovascular; Treatment; Outcome; Recovery; ACUTE ISCHEMIC-STROKE; LARGE VESSEL OCCLUSION; RETRIEVAL; MULTICENTER;

D O I：

10.1007/s00062-023-01264-4

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

IntroductionCombined stent-retriever/large-bore distal aspiration catheter (LB-DAC) thrombectomy was recently introduced to treat large-vessel occlusion; however, it is unclear whether larger inner diameters improve outcomes. We compared angiographic and clinical outcomes in patients with occlusions of the M1 segment of the middle cerebral artery treated with mechanical thrombectomy using extra-LB-DAC versus LB-DAC in combination with stent-retrievers.MethodsWe analyzed consecutive patients with M1 occlusion included in the ROSSETTI registry treated with non-balloon guide catheter combined LB-DAC/stent-retriever thrombectomy between June 2019 and April 2022. We compared demographics, baseline clinical variables, procedural variables, angiographic outcomes, and clinical outcomes [National Institute of Health Stroke Scale score at 24 h (24h-NIHSS) and modified Rankin scale score at 3 months] between patients treated with extra-LB-DAC (Sofia Plus, MIVI Q6, Catalyst7; inner diameter, 0.068 ''-0.070 '') versus LB-DAC (Sofia 5F, MIVI Q5, Catalyst 6; inner diameter, 0.055 ''-0.064 ''). Primary outcome was the first-pass effect (FPE) rate, defined as near-complete/complete reperfusion (mTICI 2c-3) after a single pass of the device.ResultsWe included 324 patients (extra-LB-DAC, 185, 57.1% patients). Demographics, clinical data, and clinical outcomes were similar between the two groups; however, there was a trend towards improvement in National Institute of Health Stroke Scale score at 24 h (24h-NIHSS) in the cohort treated with extra-LB-DAC 9 points (IQR 4;16 points) vs. 12 points (IQR 4;18 points, P = 0.083). Patients treated with extra-LB-DAC had higher FPE rate (47% vs. 30.9%; P = 0.003) and higher modified FPE (mTICI >= 2b after a single pass) rate (65.9% vs 46.8%; P = 0.001). The use of extra-LB-DAC was an independent factor in predicting FPE (odds ratio 1.982, 95% confidence interval 1.250-3.143, P = 0.004).ConclusionOur results suggest that in combined LB-DAC/stent-retriever thrombectomy, a larger aspiration catheter inner diameter is associated with higher rates of FPE and mFPE.

引用

页码：701 / 708

页数：8

共 40 条

[1] First-Pass Effect in M1-Occlusion Stroke Patients Treated with Combined Stent-Retriever/Large-Bore Distal Aspiration Catheter Thrombectomy
S. Remollo
M. Werner
J. Blasco
A. López-Rueda
L. San Roman
E. Jimenez-Gomez
I. Bravo Rey
P. Vega
E. Murias
S. Rosati
C. Pérez-García
E. González
X. Manso
S. Aixut
O. Chirife Chaparro
M. Terceño
S. Bashir
J. M. Pumar
E. Ruiz-González
J. C. Méndez
Y. Aguilar Tejedor
J. Zamarro
M. Castaño
P. Daunis-I-Estadella
J. Puig
Clinical Neuroradiology, 2023, 33 : 701 - 708
[2] Predictors of First-Pass Effect in Endovascular Thrombectomy With Stent-Retriever Devices for Acute Large Vessel Occlusion Stroke
Chen, Chu
Zhang, Tangqin
Xu, Youqing
Xu, Xiangjun
Xu, Junfeng
Yang, Ke
Yuan, Lili
Yang, Qian
Huang, Xianjun
Zhou, Zhiming
FRONTIERS IN NEUROLOGY, 2022, 13
[3] Effect of manual aspiration thrombectomy using large-bore aspiration catheter for acute basilar artery occlusion: comparison with a stent retriever system
Jin Wook Choi
Miran Han
Jung Hyun Park
Woo Sang Jung
BMC Neurology, 20
[4] Effect of manual aspiration thrombectomy using large-bore aspiration catheter for acute basilar artery occlusion: comparison with a stent retriever system
Choi, Jin Wook
Han, Miran
Park, Jung Hyun
Jung, Woo Sang
BMC NEUROLOGY, 2020, 20 (01)
[5] Comparison of First-Pass Effect in Aspiration vs. Stent-Retriever for Acute Intracranial ICA Occlusion
Hernandez, David
Serrano, Elena
Molins, Gemma
Zarco, Federico
Chirife, Oscar
Werner, Mariano
Lara, Blanca
Ramos, Anna
Llull, Laura
Requena, Manuel
Cuevas, Marta de Dios las
Remollo, Sebastian
Pinana, Carlos
Lopez-Rueda, Antonio
FRONTIERS IN NEUROLOGY, 2022, 13
[6] Impact of aspiration catheter size on first-pass effect in the combined use of contact aspiration and stent retriever technique
Perez-Garcia, Carlos
Maegerlein, Christian
Rosati, Santiago
Ruether, Charlotte
Gomez-Escalonilla, Carlos
Zimmer, Claus
Arrazola, Juan
Berndt, Maria Teresa
Moreu, Manuel
STROKE AND VASCULAR NEUROLOGY, 2021, 6 (04) : 553 - 560
[7] The ANTRACK Technique: Employing a Compliant Balloon or Stent Retriever to Advance a Large-Bore Catheter to an Occlusion During Thrombectomy Procedures in Acute Stroke Patients
Lin, Chuan-Min
Wu, Yi-Ming
Chang, Chien-Hung
Chen, Ching-Chang
Wang, Alvin Yi-Chou
OPERATIVE NEUROSURGERY, 2019, 16 (06) : 692 - 699
[8] Aspiration Thrombectomy Versus Stent-Retriever Thrombectomy for the First-Pass Therapy of Intracranial Atherosclerosis-Related Large Vessel Occlusion: A Post Hoc Analysis of The Endovascular Treatment With Versus Without Tirofiban for Patients with Large Vessel Occlusion Stroke Trial
Huang, Chu-Ming
Hong, Yi-Fan
He, Wen-Cheng
Li, Feng-Li
Xu, Chu-Kai
Wen, Chao
Ye, Yu-Dong
Cai, Chu-Wei
WORLD NEUROSURGERY, 2024, 183 : E366 - E371
[9] Optimizing fast first pass complete reperfusion in acute ischemic stroke - the BADDASS approach (BAlloon guiDe with large bore Distal Access catheter with dual aspiration with Stent-retriever as Standard approach)
Ospel, J. M.
Volny, O.
Jayaraman, M.
McTaggart, R.
Goyal, M.
EXPERT REVIEW OF MEDICAL DEVICES, 2019, 16 (11) : 955 - 963
[10] Effect of distal access catheter tip position on angiographic and clinical outcomes following thrombectomy using the combined stent-retriever and aspiration approach
Baek, Sang Hun
Kim, Sanghyeon
Kang, Myongjin
Choi, Jae-Hyung
Kwon, Hee Jin
Kim, Dong Won
PLOS ONE, 2021, 16 (06):

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