Acute thromboses and occlusions of dual layer carotid stents in endovascular treatment of tandem occlusions
| Autor: | Erasmia Broussalis, Michel Piotin, Martin Bendszus, Ansgar Berlis, Hendrik Janssen, Fritz Wodarg, Frank Runck, Raphaël Blanc, Johannes Hensler, Christoph Maurer, Vincent Costalat, Markus A Möhlenbruch, Cyril Dargazanli, Monika Killer-Oberpfalzer, Johannes Pfaff |
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| Přispěvatelé: | Heidelberg University Hospital [Heidelberg], University of Augsburg [Augsburg], University of Salzburg, Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Klinikum Nürnberg Nord, Klinikum Ingolstadt, Hôpital Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Neuroradiologie[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Universität Augsburg [Augsburg], University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein (UKSH), Kiel University |
| Rok vydání: | 2019 |
| Předmět: |
Carotid Artery Diseases
Male [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging medicine.medical_treatment 030204 cardiovascular system & hematology 0302 clinical medicine MESH: Risk Factors Risk Factors Occlusion Stent Stroke Thrombectomy MESH: Treatment Outcome MESH: Aged MESH: Middle Aged Endovascular Procedures General Medicine Middle Aged Thrombosis 3. Good health Europe Treatment Outcome [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] Female Stents Internal carotid artery Carotid Artery Internal medicine.medical_specialty MESH: Carotid Artery Internal MESH: Endovascular Procedures [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery 03 medical and health sciences medicine.artery medicine Humans MESH: Thrombosis ddc:610 cardiovascular diseases Thrombus Aged Retrospective Studies MESH: Humans MESH: Carotid Artery Diseases business.industry MESH: Retrospective Studies medicine.disease MESH: Male Surgery MESH: Stents Stenosis Carotid artery occlusion MESH: Europe Neurology (clinical) business MESH: Female 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurointerventional Surgery Journal of Neurointerventional Surgery, BMJ Journals, 2019, 12 (1), pp.33-37. ⟨10.1136/neurintsurg-2019-015032⟩ |
| ISSN: | 1759-8486 1759-8478 |
| DOI: | 10.1136/neurintsurg-2019-015032⟩ |
| Popis: | PurposeTo evaluate the occurrence and risk factors of acute in-stent thrombosis or stent occlusion in patients with tandem occlusions receiving intracranial mechanical thrombectomy and emergent extracranial internal carotid artery stenting with a dual layer carotid stent.MethodsMulticenter retrospective data collection and analysis of stroke databases of seven comprehensive stroke centers from three European countries.ResultsOverall, 160 patients (mean (SD) age 66 (12) years; 104 men (65%); median (IQR) baseline NIHSS 14 (9–18); IV lysis, n=97 (60.6%)) were treated for a cervical carotid artery occlusion or stenosis using a CASPER stent (MicroVention), and received mechanical thrombectomy for an intracranial occlusion between April 2014 and November 2018. During the procedure or within 72 hours, formation of thrombus and complete occlusion of the CASPER stent was observed in 33/160 (20.8%) and in 12/160 patients (7.5%), respectively. In 25/33 (75.8%) and in 9/12 patients (75%), respectively, this occurred during the procedure. No statistically significant difference was observed between patients with and without thrombus formation with regard to pre-existing long term medication with anticoagulants or intraprocedural administration of heparin, acetylsalicylic acid (ASA), or heparin and ASA. Favorable early neurological outcome was similar in patients with (n=15; 45.5%) and without (n=63; 49.6%) thrombus formation at the CASPER stent.ConclusionAcute thrombosis or occlusion of CASPER stents in thrombectomy patients receiving emergent extracranial internal carotid artery stenting for tandem occlusions were observed more often during the procedure than within 72 hours of follow-up, were less frequent then previously reported, and showed no impact on early neurological outcome. |
| Databáze: | OpenAIRE |
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