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

[31] Thrombectomy Outcomes in Acute Ischemic Stroke due to Middle Cerebral Artery M2 Occlusion with Stent-Retriever, Aspiration, MERCI: Multi-Center Experience
Atchaneeyasakul, Kunakorn
Malik, Amer M.
Yavagal, Dileep R.
Bouslama, Mehdi
Haussen, Diogo C.
Kenmuir, Cynthia L.
Jadhav, Ashutosh P.
Jovin, Tudor G.
Nogueira, Raul G.
STROKE, 2017, 48
[32] ASPIRATION VERSUS STENT-RETRIEVER FIRST: A SINGLE-CENTER OPEN-LABEL RANDOMIZED CONTROLLED TRIAL ON ENDOVASCULAR THROMBECTOMY FOR ACUTE LARGE VESSEL OCCLUSION ISCHEMIC STROKE IN HONG KONG
Tsang, A. C. O.
Tse, M. Y. M.
Lee, R.
Tsang, F. C. P.
Ho, W. S.
Lui, W. M.
INTERNATIONAL JOURNAL OF STROKE, 2020, 15 (1_SUPPL) : 177 - 177
[33] THROMBECTOMY OUTCOMES IN ACUTE ISCHEMIC STROKE DUE TO MIDDLE CEREBRAL ARTERY M2 OCCLUSION WITH STENT-RETRIEVER, ASPIRATION, AND MERCI: A MULTI-CENTER EXPERIENCE
Atchaneeyasakul, K.
Malik, A.
Yavagal, D.
Haussen, D.
Jadhav, A.
Bouslama, M.
Kenmuir, C.
Desai, S.
Grossberg, J.
Chaturvedi, S.
Jovin, T.
Nogueira, R.
INTERNATIONAL JOURNAL OF STROKE, 2018, 13 : 10 - 11
[34] First-Line Use of Contact Aspiration or Stent Retriever Thrombectomy for Large Vessel Occlusion Stroke Lessons From the COMPASS and ASTER Trials
Turc, Guillaume
Kim, Anthony S.
STROKE, 2019, 50 (09) : 2634 - 2636
[35] Addition of intracranial aspiration to balloon guide catheter does not improve outcomes in large vessel occlusion anterior circulation stent retriever based thrombectomy for acute stroke
Blasco, Jordi
Puig, Josep
Lopez-Rueda, Antonio
Daunis-i-Estadella, Pepus
Llull, Laura
Zarco, Federico
Macias, Napoleon
Macho, Juan
Gonzalez, Eva
Labayen, Ion
Vega, Pedro
Murias, Eduardo
Jimenez-Gomez, Elvira
Bravo Rey, Isabel
Moreu, Manuel
Perez-Garcia, Carlos
Chirife Chaparro, Oscar
Aixut, Sonia
Terceno, Mikel
Werner, Mariano
Pumar, Jose Manuel
Aguilar Tejedor, Yeray
Mendez, Jose Carlos
Moliner, Sarai
Nogueira, Raul G.
San Roman, Luis
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2022, 14 (09) : 863 - 867
[36] Predictive Factors of First-Pass Effect in Patients Who Underwent Successful Endovascular Thrombectomy for Emergent Large Vessel Occlusion
Lee, In-Hyoung
Choi, Jong-Il
Ha, Sung-Kon
Lim, Dong-Jun
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, 2024, 67 (01) : 14 - 21
[37] Stent retriever versus aspiration based thrombectomy: impact on first pass reperfusion, procedure time, and clinical outcomes in large vessel occlusion. Nationwide registry based cohort study
Karlsson, Adrian
Jood, Katarina
Bjorkman-Burtscher, Isabella
Rentzos, Alexandros
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2024,
[38] FIRST PASS EFFECT OF THROMBECTOMY WITH THE PENUMBRA SYSTEM IN PATIENTS WITH LARGE VESSEL OCCLUSION ACUTE ISCHEMIC STROKE, AN ANALYSIS OF THE COMPLETE REGISTRY
Fifi, J.
Hassan, A.
Zaidat, O.
INTERNATIONAL JOURNAL OF STROKE, 2020, 15 (1_SUPPL) : 82 - 82
[39] First-Pass Effect With Aspiration Thrombectomy With the Penumbra System in Patients With Acute Ischemic Stroke: A Core Laboratory-Adjudicated Subset Analysis of the COMPLETE Registry
Fifi, Johanna T.
Matsoukas, Stavros
Hassan, Ameer E.
Zaidat, Osama O.
STROKE-VASCULAR AND INTERVENTIONAL NEUROLOGY, 2023, 3 (03):
[40] Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion The ASTER Randomized Clinical Trial
Lapergue, Bertrand
Blanc, Raphael
Gory, Benjamin
Labreuche, Julien
Duhamel, Alain
Marnat, Gautier
Saleme, Suzana
Costalat, Vincent
Bracard, Serge
Desal, Hubert
Mazighi, Mikael
Consoli, Arturo
Piotin, Michel
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 318 (05): : 443 - 452

← 1 2 3 4 →