Impact of thrombus surface on first pass reperfusion in contact aspiration and stent retriever thrombectomy
| Autor: | Johannes Gerber, Robert Winzer, Daniel Kaiser, Kevin Hädrich, Volker Puetz, Dirk Daubner, Pawel Krukowski, Lars-Peder Pallesen, Hannes Wahl, Jennifer Linn, Katharina Laske |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Ischemia 030204 cardiovascular system & hematology Brain Ischemia 03 medical and health sciences 0302 clinical medicine medicine.artery Internal medicine Occlusion Humans Paracentesis Medicine Prospective Studies Thrombus Stroke Aged Retrospective Studies Thrombectomy Aged 80 and over medicine.diagnostic_test business.industry Angiography Digital Subtraction Thrombosis Retrospective cohort study General Medicine Digital subtraction angiography Middle Aged medicine.disease Treatment Outcome Reperfusion Middle cerebral artery Angiography Cardiology Female Stents Surgery Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of NeuroInterventional Surgery. 13:221-225 |
| ISSN: | 1759-8486 1759-8478 |
| DOI: | 10.1136/neurintsurg-2020-016194 |
| Popis: | BackgroundTo assess whether thrombus surface morphology has an impact on first pass reperfusion in contact aspiration (CA) and stent retriever (SR) thrombectomy.MethodsFrom January 2016 to December 2018, consecutive stroke patients with an occlusion of the middle cerebral artery and thrombectomy (CA or SR) were examined in this retrospective study. We assessed patients’ characteristics, procedural data and clinical outcome. Thrombus surface on pretreatment digital subtraction angiography (DSA) was categorized into regular versus irregular phenotype by blinded three-reader-consensus. Primary outcome was successful reperfusion (modified treatment in cerebral ischemia (mTICI) 2b-3) after first pass. Data analysis was stratified according to thrombectomy technique and thrombus phenotype.ResultsAmong 203 patients (76 years (IQR 65.5–81.9), 47.3% male, National Institutes of Health Stroke Scale Score 16 (IQR 12–20)), 155 patients were treated primarily with CA and 48 with SR. 40% (n=62/155) CA and 41.7% (n=20/48) SR-treated patients had a regular thrombus phenotype. In the CA group, successful reperfusion after first pass was more frequently obtained in patients with regular compared with irregular phenotype (69.4% (n=43/62) vs 34.4% (n=32/93); PConclusionDirect CA is associated with higher rates of successful first pass reperfusion in patients with a regular thrombus phenotype in pretreatment DSA. |
| Databáze: | OpenAIRE |
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