Direct Aspiration Versus Combined Technique for Anterior Distal, Medium Vessel Occlusions Stroke: The JET Distal Vessel Occlusion Study.

Autor:	Palmisano V; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Simonetti L; Department of Neurology and Stroke Center, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy., Marotti N; Angiography and Interventional Radiology Unit, Department of Radiology, University Hospital of Udine, Udine, Italy., Reverberi L; Neuroradiology, University Hospital Modena, Modena, Italy., Comai A; Department of Neuroradiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University, Bolzano, Italy., Ganimede MP; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Comelli S; Neuroradiology Unit, ARNAS 'G. Brotzu', Cagliari, Italy., Taglialatela F; Department of Neurology and Stroke Center, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy., Zini A; Department of Neurology and Stroke Center, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy., Paolucci M; Department of Neurology and Stroke Center, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Maggiore Hospital, Bologna, Italy., Sponza M; Angiography and Interventional Radiology Unit, Department of Radiology, University Hospital of Udine, Udine, Italy., Ciardi C; Angiography and Interventional Radiology Unit, Department of Radiology, University Hospital of Udine, Udine, Italy., Verganti L; Neuroradiology, University Hospital Modena, Modena, Italy., Vallone S; Neuroradiology, University Hospital Modena, Modena, Italy., Gorgatti T; Department of Neuroradiology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University, Bolzano, Italy., Franchini E; Department of Neurology, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University, Bolzano, Italy., Marrazzo A; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Paladini A; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Della Malva G; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Barone M; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Briatico Vangosa A; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Di Stasi C; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Burdi N; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy., Semeraro V; Radiology and Neuroradiology Department, 'SS. Annunziata' Hospital, Taranto, Italy.
Jazyk:	angličtina
Zdroj:	Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2024 Nov 12. Date of Electronic Publication: 2024 Nov 12.
DOI:	10.1227/ons.0000000000001411
Abstrakt:	Background and Objectives: The optimal mechanical thrombectomy technique for distal, medium vessel occlusion (DMVO) stroke remains unknown. We aimed to compare the safety and efficacy of 2 thrombectomy first-line approaches, direct aspiration (DA), and combined technique (CT) in patients with DMVOs. Methods: We conducted a retrospective review of a prospectively collected multicenter database of patients with DMVOs (at or distal to M2 and A1), who underwent mechanical thrombectomy with JET D reperfusion catheters between January 2020 and December 2021. The primary end point was the rate of first-pass complete recanalization, defined as modified treatment in cerebral infarction (mTICI) 3. The hemorrhagic complications, the 90 days functional independence rate (modified Rankin Scale 0-2), and mortality were also evaluated. Results: A total of 171 consecutive patients were enrolled (95 in DA and 76 in CT cohort). The 2 groups had comparable demographics and baseline characteristics. The DA group had a higher rate of first-pass effect (40.0% vs 10.5%, P < .001), final mTICI 2b-3 (89.5% vs 71.1%, P = .003) and final mTICI 3 (58.9% vs 28.9%, P < .001), shorter groin to reperfusion time (65 ± 43 min vs 101 ± 60 min, P < .001), and higher rate of 90-day functional independence (63.7% vs 36.1%; P = .001) compared with the CT group. There were no significant differences in hemorrhagic complications between the 2 groups. The DA group showed a lower rate of 90-day mortality (9.9% vs 27.8%; P = .004). Conclusion: In patients with DMVOs, DA with a distal dedicated reperfusion catheter appears to demonstrate better safety and efficacy when compared with the CT using the same catheter. (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
Databáze:	MEDLINE
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