Three-dimensional rotational angiography improves mechanical thrombectomy recanalization rate for acute ischaemic stroke due to middle cerebral artery M2 segment occlusions.

Autor:	Rosi A; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland.; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland., Bernava G; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland.; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland., Hofmeister J; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland.; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland., Nicolò M; Neuroradiology, Verona University Hospital, Verona, Italy., Boto J; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland., Yilmaz H; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland., Reymond P; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland.; Departement of Surgery, 27230Geneva University Hospitals, Geneva, Switzerland., Brina O; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland.; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland., Muster M; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland.; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland., Carrera E; Division of Neurology, Department of Neurosciences, 27230Geneva University Hospitals, Geneva, Switzerland., Lövblad KO; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland., Machi P; Division of Diagnostic and Interventional Neuroradiology, Department of Diagnostics, 27230Geneva University Hospitals, Geneva, Switzerland.; Brain Endovascular Therapeutics Research and Development Laboratory, Radiology and Medical Informatics, 27212University of Geneva, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences [Interv Neuroradiol] 2022 Dec 18, pp. 15910199221145745. Date of Electronic Publication: 2022 Dec 18.
DOI:	10.1177/15910199221145745
Abstrakt:	Background: Occlusions of the middle cerebral artery (MCA) M2 segments can be difficult to address with mechanical thrombectomy (MTB) using standard projections and this can affect the final recanalization. Three-dimensional rotational angiography (3D-RA) allows to obtain a 3D model of cerebral vessels in a few seconds and to determine the best two-dimensional (2D) projections to be selected to evaluate and treat cerebrovascular diseases, such as aneurysms or vascular malformations. We aimed to determine if 3D-RA could be applied also in MTB. Methods: A retrospective review of two patient cohorts treated during two time periods of 12 months before and after the introduction of 3D-RA use at our institution for MTB in M2 occlusions. Analyses were conducted to compare the two groups for procedural characteristics, such as timing, recanalization rate and complications and clinical outcome. Results: One hundred acute ischaemic stroke (AIS) patients (3D-RA group = 57; controls = 43) underwent MTB for an M2 occlusion during the two study periods. Recanalization rates were significantly higher in cases treated with 3D-RA. The mean 3D technique thrombectomy time was compared to that of non-3D cases (47 vs. 49 min, respectively). Conclusions: Our findings showed that 3D-RA is a useful tool to select specific working projections to AIS patients presenting an M2 occlusion by improving final recanalization compared to standard projections, without increasing the overall procedural time.
Databáze:	MEDLINE
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