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Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure
OBJECTIVE: To report the outcomes of thrombectomy for arterial occlusion involving the major arteries of the cerebral anterior circulation when an aspiration catheter (AC) was used in all cases, with the retrieval technique chosen during the procedure. METHODS: Of the 126 patients who underwent endo...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Japanese Society for Neuroendovascular Therapy
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370622/ https://www.ncbi.nlm.nih.gov/pubmed/37502031 http://dx.doi.org/10.5797/jnet.oa.2021-0002 |
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author | Ogino, Tatsuya Shindo, Koichiro Tatsuta, Yasuyuki Sakurai, Suguru Endo, Hideki Kamiyama, Kenji Osato, Toshiaki Nakamura, Hirohiko |
author_facet | Ogino, Tatsuya Shindo, Koichiro Tatsuta, Yasuyuki Sakurai, Suguru Endo, Hideki Kamiyama, Kenji Osato, Toshiaki Nakamura, Hirohiko |
author_sort | Ogino, Tatsuya |
collection | PubMed |
description | OBJECTIVE: To report the outcomes of thrombectomy for arterial occlusion involving the major arteries of the cerebral anterior circulation when an aspiration catheter (AC) was used in all cases, with the retrieval technique chosen during the procedure. METHODS: Of the 126 patients who underwent endovascular thrombectomy during the 2-year period of 2018–2019, the study subjects were 102 patients with arterial occlusion involving the major arteries of the cerebral anterior circulation. Patients were divided into two groups depending on when the procedure was performed. In the earlier group (January 2018–March 2019), treatment was performed using only a stent retriever (SR), whereas an AC was used for all cases in the later group (April–December 2019). Outcomes between groups were retrospectively compared. In the later group, the treatment strategy was to use the SR in combination with the AC (combined technique) for retrieval if the microcatheter reached the distal side of the occlusion site without difficulty. If the microcatheter did not easily reach the distal side, we did not stick to penetrating the occlusion site, and contact aspiration was performed. RESULTS: Thrombolysis in cerebral infarction (TICI) grade 2b–3 was achieved in 85% of patients in the earlier group and 95% in the later group. TICI grade 3 was achieved in 52% of the earlier group and 54% of the later group, showing no significant difference. TICI grade 2b–3 was achieved at first pass in 46% of patients in the earlier group, significantly lower than the 71% in the later group (P = 0.013). The mean number of passes decreased significantly from 1.84 in the earlier group to 1.32 in the later group (P = 0.002). CONCLUSION: Using an AC from the start, and using a combined technique when the microcatheter reached the distal side of the occlusion site, the frequency of first-pass TICI grade 2b-3 increased, and the mean number of passes decreased in comparison with the SR-alone group. |
format | Online Article Text |
id | pubmed-10370622 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japanese Society for Neuroendovascular Therapy |
record_format | MEDLINE/PubMed |
spelling | pubmed-103706222023-07-27 Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure Ogino, Tatsuya Shindo, Koichiro Tatsuta, Yasuyuki Sakurai, Suguru Endo, Hideki Kamiyama, Kenji Osato, Toshiaki Nakamura, Hirohiko J Neuroendovasc Ther Original Article OBJECTIVE: To report the outcomes of thrombectomy for arterial occlusion involving the major arteries of the cerebral anterior circulation when an aspiration catheter (AC) was used in all cases, with the retrieval technique chosen during the procedure. METHODS: Of the 126 patients who underwent endovascular thrombectomy during the 2-year period of 2018–2019, the study subjects were 102 patients with arterial occlusion involving the major arteries of the cerebral anterior circulation. Patients were divided into two groups depending on when the procedure was performed. In the earlier group (January 2018–March 2019), treatment was performed using only a stent retriever (SR), whereas an AC was used for all cases in the later group (April–December 2019). Outcomes between groups were retrospectively compared. In the later group, the treatment strategy was to use the SR in combination with the AC (combined technique) for retrieval if the microcatheter reached the distal side of the occlusion site without difficulty. If the microcatheter did not easily reach the distal side, we did not stick to penetrating the occlusion site, and contact aspiration was performed. RESULTS: Thrombolysis in cerebral infarction (TICI) grade 2b–3 was achieved in 85% of patients in the earlier group and 95% in the later group. TICI grade 3 was achieved in 52% of the earlier group and 54% of the later group, showing no significant difference. TICI grade 2b–3 was achieved at first pass in 46% of patients in the earlier group, significantly lower than the 71% in the later group (P = 0.013). The mean number of passes decreased significantly from 1.84 in the earlier group to 1.32 in the later group (P = 0.002). CONCLUSION: Using an AC from the start, and using a combined technique when the microcatheter reached the distal side of the occlusion site, the frequency of first-pass TICI grade 2b-3 increased, and the mean number of passes decreased in comparison with the SR-alone group. The Japanese Society for Neuroendovascular Therapy 2021-04-07 2022 /pmc/articles/PMC10370622/ /pubmed/37502031 http://dx.doi.org/10.5797/jnet.oa.2021-0002 Text en ©2022 The Japanese Society for Neuroendovascular Therapy https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Original Article Ogino, Tatsuya Shindo, Koichiro Tatsuta, Yasuyuki Sakurai, Suguru Endo, Hideki Kamiyama, Kenji Osato, Toshiaki Nakamura, Hirohiko Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure |
title | Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure |
title_full | Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure |
title_fullStr | Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure |
title_full_unstemmed | Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure |
title_short | Mechanical Thrombectomy Making Practical Use of an Aspiration Catheter While Selecting the Retrieval Technique during the Procedure |
title_sort | mechanical thrombectomy making practical use of an aspiration catheter while selecting the retrieval technique during the procedure |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370622/ https://www.ncbi.nlm.nih.gov/pubmed/37502031 http://dx.doi.org/10.5797/jnet.oa.2021-0002 |
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