Vessel diameter and catheter-to-vessel ratio affect the success rate of clot aspiration
| Autor: | Hannes Leischner, Fabian Flottmann, Anna Andriana Kyselyova, Jens Fiehler, Andreas Frölich, J. H. Buhk |
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| Rok vydání: | 2020 |
| Předmět: |
Aortic arch
Male medicine.medical_specialty Catheters medicine.medical_treatment Revascularization Brain Ischemia medicine.artery Medicine Humans Thrombus Stroke Aged Retrospective Studies Thrombectomy Aged 80 and over Groin business.industry Cerebral infarction Infarction Middle Cerebral Artery General Medicine Thrombolysis Middle Aged medicine.disease Surgery Catheter medicine.anatomical_structure Treatment Outcome Female Neurology (clinical) business Vascular Access Devices |
| Zdroj: | Journal of neurointerventional surgery. 13(7) |
| ISSN: | 1759-8486 |
| Popis: | BackgroundA direct aspiration first pass technique (ADAPT) is an efficient, safe, cost-effective, and fast thrombectomy technique.ObjectiveTo evaluate anatomical and clot characteristics associated with success of the aspiration component as part of ADAPT.Methods106 cases of acute carotid-T, basilar, and middle cerebral artery occlusion undergoing endovascular treatment with ADAPT were retrospectively assessed for successful catheter-clot contact and successful primary aspiration, defined as a Thrombolysis in Cerebral Infarction score ≥2b after primary aspiration with 5F or 6F aspiration catheters. Patient age, National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset to groin puncture, time from groin puncture to revascularization, aortic arch type, access vessel tortuosity, vessel diameter at the proximal end of the thrombus, catheter-to-vessel ratio (CVR), clot density, length, and perviousness were determined.ResultsSuccessful clot contact with the aspiration catheter was achieved in 76 cases (72%); these patients were younger (67.7±15.2 vs 73.7±11.4 years; p=0.05) and had less tortuous access vessels (1 vs 2 reverse curves; p=0.004) than those in whom clot contact failed. Successful primary aspiration occurred in 36 of these cases (47%) and was associated with significantly smaller vessel diameter at the proximal thrombus end (2.5±0.7 mm vs 3.1±1.3 mm; p=0.01) and higher CVR (CVR outer diameter: 0.85±0.2 vs 0.68±0.2; p=0.01 and CVR inner diameter: 0.72±0.2 vs 0.58±0.2; pConclusionWith ADAPT, patient age and vessel tortuosity affect the ability to deliver the aspiration catheter and achieve clot contact, whereas vessel diameter and CVR at the aspiration site seem to affect the effectiveness of clot aspiration. Strategies aimed at improving catheter deliverability and increasing CVR may increase the efficacy of ADAPT. |
| Databáze: | OpenAIRE |
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