Comparison of aspiration versus combined technique as first-line approach in terminal internal carotid artery occlusion: a multicenter experience.

Autor:	Diana F; Department of Neuroradiology, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy francesco.diana.md@gmail.com., Vinci SL; Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy., Ruggiero M; Neuroradiology Unit, AUSL Romagna, Maurizio Bufalini Hospital, Cesena, Italy., Semeraro V; Department of Diagnostic and Interventional Imaging, Santissima Annunziata Hospital, Taranto, Italy., Bracco S; Unit of Interventional Neuroradiology, Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico 'Santa Maria Alle Scotte', Siena, Italy., Frauenfelder G; Department of Neuroradiology, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy., Paolucci A; Unit of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy., Cirillo L; Neuroradiology Unit, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy.; DIBINEM, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Pesce A; Department of Neurosurgery, Ospedale Santa Maria Goretti, Latina, Italy., Tessitore A; Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy., Commodaro C; Neuroradiology Unit, AUSL Romagna, Maurizio Bufalini Hospital, Cesena, Italy., Ganimede MP; Department of Diagnostic and Interventional Imaging, Santissima Annunziata Hospital, Taranto, Italy., Zanoni M; Unit of Interventional Neuroradiology, Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico 'Santa Maria Alle Scotte', Siena, Italy., Saponiero R; Department of Neuroradiology, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy., Zini A; Department of Neurology and Stroke Center, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy., Velo M; Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy., Modello B; Neuroradiology Unit, AUSL Romagna, Maurizio Bufalini Hospital, Cesena, Italy., Burdi N; Department of Diagnostic and Interventional Imaging, Santissima Annunziata Hospital, Taranto, Italy., Cioni S; Unit of Interventional Neuroradiology, Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico 'Santa Maria Alle Scotte', Siena, Italy., Simonetti L; Neuroradiology Unit, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy., Romano DG; Department of Neuroradiology, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2022 Jul; Vol. 14 (7), pp. 666-671. Date of Electronic Publication: 2021 Aug 04.
DOI:	10.1136/neurintsurg-2021-017585
Abstrakt:	Background: There is no consensus on the most effective endovascular technique to use in patients with acute ischemic stroke due to terminal internal carotid artery (ICA) occlusion. The aim of this study was to compare safety and efficacy of the aspiration technique (AT) and combined technique (CT) as first-line approach in terminal ICA occlusions. Methods: We performed a retrospective analysis of prospectively collected databases from seven Italian stroke centers. Patients were divided into two subgroups according to the first-line approach: AT group or CT group. We followed the STROBE guidelines for cohort studies. We used Chi-square test, one-way and multivariate ANOVA analysis, together with contrast analysis and post hoc tests, logistic regression and Pearson's bivariate correlation for the statistical analyses. Results: Between January 2018 and August 2020, 353 patients were treated for a terminal ICA occlusion, with either AT or CT. CT was associated with a higher Thrombolysis in Cerebral Infarction (TICI) 2B-3 after the first pass (51.0% vs 26.9%) and at the end of the procedure (84% vs 73.3%) and with an improved clinical outcome at discharge (modified Rankin Scale (mRs) 0-2 of 47.8% vs 34.0%) and at 3 months' follow-up (mRs 0-2 of 56.5% vs 38.9%) compared with AT. Conclusion: Thrombectomy of terminal ICA occlusions obtained using CT as first-line approach demonstrated better technical and functional outcomes in comparison with AT. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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