Impact of double stent retriever configuration on first-pass effect in stroke: a multicenter study.

Autor:	Pérez-García C; Interventional Neuroradiology, Hospital Clinico San Carlos, Madrid, Spain., Castaño M; Interventional Neuroradiology, Hospital Universitario de Salamanca, Salamanca, Spain., Llibre JC; Interventional Neuroradiology, Hospital Universitario de Salamanca, Salamanca, Spain., Vargas L; Interventional Neuroradiology, Hospital Universitario de Salamanca, Salamanca, Spain., López-Frías A; Interventional Neuroradiology, Hospital Clinico San Carlos, Madrid, Spain alfonsolflj@gmail.com., Rosati S; Interventional Neuroradiology, Hospital Clinico San Carlos, Madrid, Spain., López JL; Interventional Neuroradiology, Hospital Universitario de Burgos, Burgos, Spain., Venegas J; Interventional Neuroradiology, Hospital Universitario de Burgos, Burgos, Spain., González E; Interventional Neuroradiology, Hospital Universitario Cruces, Barakaldo, Spain., Fondevila J; Interventional Neuroradiology, Hospital Universitario Cruces, Barakaldo, Spain., Espinosa de Rueda M; Interventional Neuroradiology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain., Zamarro J; Interventional Neuroradiology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain., Baldi S; Interventional Neuroradiology, Complejo Asistencial Universitario de Leon, Leon, Spain., Díaz T; Interventional Neuroradiology, Hospital Regional Universitario de Malaga, Malaga, Spain., de la Rosa C; Interventional Neuroradiology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain., Chaviano Grajera J; Interventional Neuroradiology, Complejo Hospitalario de Cáceres, Caceres, Spain., Ballenilla Marco F; Interventional Neuroradiology, Hospital Universitario 12 de Octubre, Madrid, Spain., Cuba V; Interventional Neuroradiology, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Spain., Muñoz Olmedo JM; Interventional Neuroradiology, Hospital Universitario de Getafe, Getafe, Spain., Mendez JC; Interventional Neuroradiology, Hospital Universitario Ramon y Cajal, Madrid, Spain., Remollo S; Interventional Neuroradiology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Bermejo R; Interventional Neuroradiology, Hospital de Navarra, Pamplona, Spain., Morales E; Interventional Neuroradiology, Hospital Universitario Basurto, Bilbao, Spain., Gómez-Escalonilla C; Neurology, Hospital Clínico San Carlos, Madrid, Spain., Moreu M; Interventional Neuroradiology, Hospital Clinico San Carlos, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2024 Sep 17. Date of Electronic Publication: 2024 Sep 17.
DOI:	10.1136/jnis-2024-022297
Abstrakt:	Background: Efficient recanalization of occluded cerebral arteries is crucial in the treatment of acute ischemic stroke. Double stent retrievers have shown the potential to enhance the rates of recanalization on the first pass. This study aims to evaluate the efficacy and safety of the double stent retriever technique and the predictors of achieving first-pass effect in patients with acute ischemic stroke. Methods: This prospective multicenter study involved 209 patients from 16 comprehensive stroke centers in Spain. Patients with occlusions in the anterior circulation were treated using the Aperio Hybrid double stent retriever. The study examined various deployment techniques, including simultaneous and sequential deployment and stent configurations, comparing the Y-shaped and parallel configurations. Results: The double stent retriever technique achieved a first-pass effect in 72.7% of cases and a final successful recanalization rate of 99.5%. The Y-shaped configuration was significantly associated with higher recanalization rates on the first pass (OR 2.59, 95% CI 1.18 to 5.68, P=0.02). Procedural complications were mild to moderate in 6.7% and severe in 1.5% of cases, with symptomatic intracranial hemorrhage occurring in 3.3% of patients. At 3 months follow-up, 57.2% of patients achieved a good clinical outcome, with a mortality rate of 15.1%. Conclusion: The findings support the efficacy of the double stent retriever technique, particularly the Y-shaped configuration, in achieving high recanalization rates on the first pass with an acceptable safety profile. This technique may offer clinical benefits for future acute ischemic stroke treatment protocols. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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